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The economic value of screening haemodialysis patients for methicillin-resistant Staphylococcus aureus in the USA.
- Source :
-
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases [Clin Microbiol Infect] 2011 Nov; Vol. 17 (11), pp. 1717-26. Date of Electronic Publication: 2011 May 20. - Publication Year :
- 2011
-
Abstract
- Methicillin-resistant Staphylococcus aureus (MRSA) can cause severe infections in patients undergoing haemodialysis. Routine periodic testing of haemodialysis patients and attempting to decolonize those who test positive may be a strategy to prevent MRSA infections. The economic value of such a strategy has not yet been estimated. We constructed a Markov computer simulation model to evaluate the economic value of employing routine testing (agar-based or PCR) at different MRSA prevalence, spontaneous clearance, costs of decolonization and decolonization success rates, performed every 3, 6 or 12 months. The model showed periodic MRSA surveillance with either test to be cost-effective (incremental cost-effectiveness ratio ≤$50 000/quality-adjusted life-year) for all conditions tested. Agar surveillance was dominant (i.e. less costly and more effective) at an MRSA prevalence ≥10% and a decolonization success rate ≥25% for all decolonization treatment costs tested with no spontaneous clearance. PCR surveillance was dominant when the MRSA prevalence was ≥20% and decolonization success rate was ≥75% with no spontaneous clearance. Routine periodic testing and decolonization of haemodialysis patients for MRSA may be a cost-effective strategy over a wide range of MRSA prevalences, decolonization success rates, and testing intervals.<br /> (© 2011 The Authors. Clinical Microbiology and Infection © 2011 European Society of Clinical Microbiology and Infectious Diseases.)
- Subjects :
- Aged
Aged, 80 and over
Anti-Bacterial Agents economics
Carrier State drug therapy
Carrier State microbiology
Cost-Benefit Analysis
Drug Therapy economics
Female
Humans
Male
Mass Screening economics
Middle Aged
Models, Statistical
Staphylococcal Infections drug therapy
Staphylococcal Infections economics
Staphylococcal Infections microbiology
United States
Anti-Bacterial Agents therapeutic use
Carrier State diagnosis
Drug Therapy methods
Mass Screening methods
Methicillin-Resistant Staphylococcus aureus isolation & purification
Renal Dialysis adverse effects
Staphylococcal Infections prevention & control
Subjects
Details
- Language :
- English
- ISSN :
- 1469-0691
- Volume :
- 17
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
- Publication Type :
- Academic Journal
- Accession number :
- 21595796
- Full Text :
- https://doi.org/10.1111/j.1469-0691.2011.03525.x