Low Yield of Methicillin-Resistant Staphylococcus aureus Screening in Hemodialysis Patients: 10 Years' Experience. (26th May 2015)

• Record Type: Journal Article
• Authors: Gebreselassie, H. M.; Kaspar, T.; Droz, S.; Marschall, J.
• Is Part Of: Infection control and hospital epidemiology. Volume 36:Number 9(2015)
• Page Start: 1046
• Page End: 1049
• Publication Date: 2015-05-26
• Subjects: Nosocomial infections -- Epidemiology -- Periodicals; Health facilities -- Sanitation -- Periodicals; Hospital buildings -- Sanitation -- Periodicals; Cross Infection -- Periodicals; Epidemiology -- Periodicals; Hospitals -- Periodicals; Infection Control -- Periodicals; 614.44
• DOI: 10.1017/ice.2015.117
• Languages: English
• ISSNs: 0899-823X

Abstract

<abstract abstract-type="normal"> <title> <x content-type="archive" xml:space="preserve">Abstract</x> </title> <sec id="abs1" sec-type="general"> <title>OBJECTIVE</title> <p>To determine the prevalence of methicillin-resistant <italic>Staphylococcus aureus</italic> (MRSA) nasal colonization in hemodialysis patients and to analyze the cost-effectiveness of our screening approach compared with an alternative strategy.</p> </sec> <sec id="abs2" sec-type="general"> <title>DESIGN</title> <p>Screening study and cost-effectiveness analysis.</p> </sec> <sec id="abs3" sec-type="methods"> <title>METHODS</title> <p>Analysis of twice-yearly MRSA prevalence studies conducted in the hemodialysis unit of a 950-bed tertiary care hospital from January 1, 2004, through December 31, 2013. For this purpose, nasal swab samples were cultured on MRSA screening agar (mannitol-oxacillin biplate).</p> </sec> <sec id="abs4" sec-type="results"> <title>RESULTS</title> <p>There were 20 mass screenings during the 10-year study period. We identified 415 patients participating in at least 1 screening, with an average of 4.5 screenings per patient. Of 415 screened patients, 15 (3.6%) were found to be MRSA carriers. The first mass screening in 2004 yielded the highest percentage of MRSA (6/101 [6%]). Only 7 subsequent screenings revealed new MRSA carriers, whereas 4 screenings confirmed previously known carriers, and 8 remained negative. None of the carriers developed MRSA bacteremia during the study period. The total cost of our screening approach, that is, screening and isolation costs, was US $93, 930. The total cost of an alternative strategy (ie, no mass screening administered) would be equivalent to costs of isolation of index cases and contact tracing was estimated to be US $5, 382 (difference, US $88, 548).</p> </sec> <sec id="abs5" sec-type="conclusions"> <title>CONCLUSIONS</title> <p>In an area of low MRSA endemicity (<5%), regular nasal screenings of a high-risk population yielded a low rate of MRSA carriers. Twice-yearly MRSA screening of dialysis patients is unlikely to be cost-effective if MRSA prevalence is low.</p> <p> <italic>Infect. Control Hosp. Epidemiol.</italic> 2015;36(9):1046–1049</p> </sec> </abstract>