The costs and benefits of hospital MRSA screening

Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) infections represent a significant challenge. Rapid and accurate identification of MRSA in hospital admissions is essential for timely treatment decisions, isolation/bio-burden reduction and reducing potential cross-transmission/acquisition of these infections. Here we present the clinical benefits and cost-effectiveness of a rapid MRSA screening programme, which was implemented at Blackpool Victoria Hospital. The economic advantages of continuing the service despite a 15% cut in overall budget are also presented. In the pre-study period (2007–2008) 20 461 emergency and 21 461 elective admissions were screened and 40 cases of MRSA bacteraemia were reported. Glycopeptide unit days were 4145. During the 12-month pilot, approximately 4% of the PCR emergency screens were positive. Nine MRSA bacteraemias were reported during this period, representing a 78% reduction over the previous year. The cost of service over 12 months was £396 285. Estimated savings from the reduction in bed days and glycopeptide use ranged from 282 266 to 329 117. Hospital-acquired (post 48 hours) MRSA bacteraemias were reduced from 28 to 5. Annual glycopeptide spend was reduced by 50%, from £251 168 (2007–2008) to £124 060 (2008–2009). Rapidly available MRSA results were used to complement clinical decision making and optimize treatment. The cost-effectiveness of any screening programme is proportional to its success. The overall benefits and savings achieved in the current study more than justified the expenditure on rapid screening, and the Trust has since adopted PCR as a regular screening service for emergency admissions.