The University of Southampton
University of Southampton Institutional Repository

Evaluation of screening risk and nonrisk patients for methicillin-resistant Staphylococcus aureus on admission in an acute care hospital

Evaluation of screening risk and nonrisk patients for methicillin-resistant Staphylococcus aureus on admission in an acute care hospital
Evaluation of screening risk and nonrisk patients for methicillin-resistant Staphylococcus aureus on admission in an acute care hospital
Background: screening for methicillin-resistant Staphylocccus aureus (MRSA) is advocated as part of control measures, but screening all patients on admission to hospital may not be cost-effective.

Objective: our objective was to evaluate the additional yield of screening all patients on admission compared with only patients with risk factors and to assess cost aspects.

Methods: a prospective, nonrandomized observational study of screening nonrisk patients ?72 hours of admission compared with only screening patients with risk factors over 3 years in a tertiary referral hospital was conducted. We also assessed the costs of screening both groups.

Results: a total of 48 of 892 (5%) patients was MRSA positive; 28 of 314 (9%) during year 1, 12 of 257 (5%) during year 2, and 8 of 321 (2%) during year 3. There were significantly fewer MRSA-positive patients among nonrisk compared with MRSA-risk patients: 4 of 340 (1%) versus 44 of 552 (8%), P ? .0001, respectively. However, screening nonrisk patients increased the number of screening samples by 62% with a proportionate increase in the costs of screening. A backward stepwise logistic regression model identified age > 70 years, diagnosis of chronic pulmonary disease, previous MRSA infection, and admission to hospital during the previous 18 months as the most important independent predictors to discriminate between MRSA-positive and MRSA-negative patients on admission (94.3% accuracy, P < .001).

Conclusion: screening patients without risk factors increased the number of screenings and costs but resulted in few additional cases being detected. In a hospital where MRSA is endemic, targeted screening of at-risk patients on admission remains the most efficient strategy for the early identification of MRSA-positive patients
0196-6553
411-415
Creamer, Eilish
c3405a02-64a1-4dda-833c-31242103525d
Galvin, Sandra
12bab9ac-3893-40e0-87e3-7b736cc00987
Dolan, Anthony
e4352412-0518-4661-9cb4-c3a853d58135
Sherlock, Orla
d09ed07b-5557-4d05-846d-67d24479da77
Dimitrov, Borislav D
366d715f-ffd9-45a1-8415-65de5488472f
Fitzgerald-Hughes, Deirdre
ca3b87b5-b37e-40cb-a151-68f6ca501154
Thomas, Toney
8ccd22ca-e6c2-41af-8880-fbd238ef38c8
Walsh, John
e1af825d-b316-462f-904d-a2bad241e3da
Moore, Joan
d88b0dee-bb50-4131-a4f6-6bc0d0000334
Smyth, Edmond G
e540599b-6e8e-4cbf-ad6b-9e1bb595d7ae
Shore, Anna C
925055c6-706c-467f-b5b5-18b458b1923b
Sullivan, Derek
95a0f7d2-c86e-4847-be21-e6e432b4df71
Kinnevey, Peter
12accab7-ac12-4e85-ba28-95925fc1d738
O'Lorcain, Piaras
490ca484-a088-488c-983e-f6cd22ae631f
Cunney, Robert
98577b3b-bd9d-401c-8f14-a3eebb8e44dc
Coleman, David C
f83a0a8b-32ac-4085-9a0e-f12674b26883
Humphreys, Hilary
0f34fe45-64ba-4291-8942-57c74f352a74
Creamer, Eilish
c3405a02-64a1-4dda-833c-31242103525d
Galvin, Sandra
12bab9ac-3893-40e0-87e3-7b736cc00987
Dolan, Anthony
e4352412-0518-4661-9cb4-c3a853d58135
Sherlock, Orla
d09ed07b-5557-4d05-846d-67d24479da77
Dimitrov, Borislav D
366d715f-ffd9-45a1-8415-65de5488472f
Fitzgerald-Hughes, Deirdre
ca3b87b5-b37e-40cb-a151-68f6ca501154
Thomas, Toney
8ccd22ca-e6c2-41af-8880-fbd238ef38c8
Walsh, John
e1af825d-b316-462f-904d-a2bad241e3da
Moore, Joan
d88b0dee-bb50-4131-a4f6-6bc0d0000334
Smyth, Edmond G
e540599b-6e8e-4cbf-ad6b-9e1bb595d7ae
Shore, Anna C
925055c6-706c-467f-b5b5-18b458b1923b
Sullivan, Derek
95a0f7d2-c86e-4847-be21-e6e432b4df71
Kinnevey, Peter
12accab7-ac12-4e85-ba28-95925fc1d738
O'Lorcain, Piaras
490ca484-a088-488c-983e-f6cd22ae631f
Cunney, Robert
98577b3b-bd9d-401c-8f14-a3eebb8e44dc
Coleman, David C
f83a0a8b-32ac-4085-9a0e-f12674b26883
Humphreys, Hilary
0f34fe45-64ba-4291-8942-57c74f352a74

Creamer, Eilish, Galvin, Sandra, Dolan, Anthony, Sherlock, Orla, Dimitrov, Borislav D, Fitzgerald-Hughes, Deirdre, Thomas, Toney, Walsh, John, Moore, Joan, Smyth, Edmond G, Shore, Anna C, Sullivan, Derek, Kinnevey, Peter, O'Lorcain, Piaras, Cunney, Robert, Coleman, David C and Humphreys, Hilary (2012) Evaluation of screening risk and nonrisk patients for methicillin-resistant Staphylococcus aureus on admission in an acute care hospital. American Journal of Infection Control, 40 (5), 411-415. (doi:10.1016/j.ajic.2011.07.008). (PMID:21962934)

Record type: Article

Abstract

Background: screening for methicillin-resistant Staphylocccus aureus (MRSA) is advocated as part of control measures, but screening all patients on admission to hospital may not be cost-effective.

Objective: our objective was to evaluate the additional yield of screening all patients on admission compared with only patients with risk factors and to assess cost aspects.

Methods: a prospective, nonrandomized observational study of screening nonrisk patients ?72 hours of admission compared with only screening patients with risk factors over 3 years in a tertiary referral hospital was conducted. We also assessed the costs of screening both groups.

Results: a total of 48 of 892 (5%) patients was MRSA positive; 28 of 314 (9%) during year 1, 12 of 257 (5%) during year 2, and 8 of 321 (2%) during year 3. There were significantly fewer MRSA-positive patients among nonrisk compared with MRSA-risk patients: 4 of 340 (1%) versus 44 of 552 (8%), P ? .0001, respectively. However, screening nonrisk patients increased the number of screening samples by 62% with a proportionate increase in the costs of screening. A backward stepwise logistic regression model identified age > 70 years, diagnosis of chronic pulmonary disease, previous MRSA infection, and admission to hospital during the previous 18 months as the most important independent predictors to discriminate between MRSA-positive and MRSA-negative patients on admission (94.3% accuracy, P < .001).

Conclusion: screening patients without risk factors increased the number of screenings and costs but resulted in few additional cases being detected. In a hospital where MRSA is endemic, targeted screening of at-risk patients on admission remains the most efficient strategy for the early identification of MRSA-positive patients

This record has no associated files available for download.

More information

e-pub ahead of print date: September 2011
Published date: 2012
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 337418
URI: http://eprints.soton.ac.uk/id/eprint/337418
ISSN: 0196-6553
PURE UUID: aeff22fe-83fe-4a52-9335-fc68efd2a7b0

Catalogue record

Date deposited: 26 Apr 2012 07:35
Last modified: 14 Mar 2024 10:53

Export record

Altmetrics

Contributors

Author: Eilish Creamer
Author: Sandra Galvin
Author: Anthony Dolan
Author: Orla Sherlock
Author: Borislav D Dimitrov
Author: Deirdre Fitzgerald-Hughes
Author: Toney Thomas
Author: John Walsh
Author: Joan Moore
Author: Edmond G Smyth
Author: Anna C Shore
Author: Derek Sullivan
Author: Peter Kinnevey
Author: Piaras O'Lorcain
Author: Robert Cunney
Author: David C Coleman
Author: Hilary Humphreys

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×