Measures to eradicate multidrug-resistant organism outbreaks: How much does it cost?

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Title: Measures to eradicate multidrug-resistant organism outbreaks: How much does it cost?
Authors: Birgand, GJC
Bourigault, C
Moore, L
Vella, V
Lepelletier, D
Holmes, A
Iucet, JC
Item Type: Journal Article
Abstract: This study aimed to assess the economic burden of infection control measures that succeeded in eradicating multidrug-resistant organisms (MDROs) in emerging epidemic contexts in hospital settings. The MEDLINE, EMBASE and Ovid databases were systematically interrogated for original English-language articles detailing costs associated with strict measures to eradicate MDROs published between 1 January 1974 and 2 November 2014. This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Overall, 13 original articles were retrieved reporting data on several MDROs, including glycopeptide-resistant enterococci (n = 5), carbapenemase-producing Enterobacteriacae (n = 1), methicillin-resistant Staphylococcus aureus (n = 5), and carbapenem-resistant Acinetobacter baumannii (n = 2). Overall, the cost of strict measures to eradicate MDROs ranged from €285 to €57 532 per positive patient. The major component of these overall costs was related to interruption of new admissions, representing €2466 to €47 093 per positive patient (69% of the overall mean cost; range, 13-100%), followed by mean laboratory costs of €628 to €5849 (24%; range, 3.3-56.7%), staff reinforcement costs of €6204 to €148 381 (22%; range, 3.3-52%), and contact precautions costs of €166 to €10 438 per positive patient (18%; range, 0.7-43.3%). Published data on the economic burden of strict measures to eradicate MDROs are limited, heterogeneous, and weakened by several methodological flaws. Novel economic studies should be performed to assess the financial impact of current policies, and to identify the most cost-effective strategies to eradicate emerging MDROs in healthcare facilities.
Issue Date: 16-Oct-2015
Date of Acceptance: 4-Oct-2015
ISSN: 1469-0691
Publisher: Elsevier
Start Page: 162.e1
End Page: 162.e9
Journal / Book Title: Clinical Microbiology and Infection
Volume: 22
Issue: 2
Copyright Statement: © 2015, Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
Sponsor/Funder: National Institute for Health Research
Imperial College Healthcare NHS Trust
Imperial College Healthcare NHS Trust- BRC Funding
National Institute for Health Research
Funder's Grant Number: RDPSC 79560
RDPSC 79560
RDA02 79560
Keywords: Carbapenemase-producing Enterobacteriaceae
carbapenem-resistant Acinetobacter baumannii
contact precautions
glycopeptide-resistant enterococci
infection control
methicillin-resistant Staphylococcus aureus
search and isolate
1103 Clinical Sciences
Publication Status: Published
Appears in Collections:Department of Medicine
Faculty of Medicine

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