Screening all patients entering three Illinois hospitals for infection with methicillin-resistant Staphylococcus aureus (MRSA) reduced the number of new cases by 70 percent and saved the hospitals over $1.8 million.
The Northshore Health System in Evanston used a rapid molecular PCR test to look MRSA colonies in the nasal passages of all newly admitted patients. Patients who were positive were isolated, treated with Bactroban® (mupirocin), and given two antiseptic baths. Nursing staff used gloves and gowns during contacts.
While the testing is expensive, Lance Peterson, MD, from Northshore told the Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) meeting this week in San Francisco that the $600,000 cost was recovered by not having to treat MRSA infections. About half of the expensive treatment is not covered by insurance.
Dr. Peterson said that the biggest risk factor for MRSA is colonization, and that about 7 in every 100 colonized patients go on to get an infection.
The PCR testing is more expensive than more commonly used cell cultures, but answers are ready in about 15 hours. Isolating patients with MRSA colonies in their noses also adds to the cost. However, each full-blown MRSA infection costs the hospital $24,000.
While some states mandate testing for patients in intensive care units, Peterson thinks this is not sufficient to control the infection. He said,
The bottom line for us is that if you want to have a successful MRSA reduction program, you have to have a very aggressive, very rapid and broad MRSA screening program.
In other news from ICAAC, a team from the University of Washington reported finding strains of staphylococci in nearly all the public beaches in the Seattle area. About half were methicillin resistant strains — MRSA.
The researchers led by Marylin C. Roberts, PhD, did not know if the bacteria found in the sand would actually translate into skin colonization or infections. However, Dr. Roberts cautioned beachgoers not to dig into sand or bury themselves, particularly if they had open cuts or scrapes or were medically fragile.
More information on the two studies from MedPage Today’s coverage of ICAAC:
- Michael Smith, ICAAC: Wide MRSA Screening Cuts Disease, Saves $$, MedPage Today, September 14, 2009.
- Crystal Pfend, ICAAC: MRSA Found on Beaches in Washington, MedPage Today, September 14, 2009.
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