K-1712. Costs and Benefits of the MRSA 'Search and Destroy' Policy in a Dutch Hospital
Session: Slide Session: MRSA Screening and Decolonization: Does it Work and is it Cost-Effective?
Sunday, October 26, 2008: 12:00 AM
Room: Independence A (Grand Hyatt)
Background: Methicillin-resistant Staphylococcus aureus (MRSA) has become an increasingly important pathogen in hospitals and recently also in the community. In Dutch hospitals the 'Search and Destroy' (S&D) policy is applied successfully. The objective of this study was to determine the yearly costs and benefits of the S&D policy over the years 2001 until 2006 in a teaching hospital with 1370 beds. Methods: Data of the infection control department and from the hospital information system were used to calculate the variable and fixed costs. Variable costs contained costs for isolations, cleaning, treatment, closure of wards and additional costs for coincidental MRSA findings. Fixed costs were divided into costs for building isolation rooms and salary of one full-time infection control practitioner. To determine the benefits of the S&D policy, the number of cases of MRSA bacteremia prevented and its associated costs and mortality were estimated. Results: In the study period 82 patients and 13 HCW were found to be MRSA positive. Thirty-three different MRSA types were found and one of them had spread in the hospital. This caused a temporary closure of 3 units for a total of 55 days. MRSA carriage of all colonized HCW was treated and together they were not allowed to work for 221 days. Yearly costs of the MRSA policy were estimated at € 215,559, equivalent to € 5.54 per patient admitted to the hospital or € 0.76 per patient day. This is 0.08% of the hospital budget. In the study period there were no patients that had a bacteremia caused by MRSA. Application of this policy was estimated to prevent 64 cases of MRSA bacteremia per year , resulting in annual savings of € 595,584 for the hospital and 15 lives per year (95% CI 9-23). Conclusions: The S&D policy is highly cost-effective.
Jan Kluytmans, MD, Prof, PhD, Amphia Hospital, Miranda van Rijen, Amphia Hospital, Breda, Netherlands and  M. M. L. van Rijen, None.