Decolonization-based strategies that utilize both intranasal mupirocin and CHG baths were preferred over other strategies even when we varied assumptions about disease probabilities, efficacy, and costs. In real world settings where healthcare facilities consider a range of strategies under constrained resources, a comprehensive model that brings together all available strategies would aid decision-making at both the local and national levels. Table 2 Incremental cost per colonization and infection averted per 10, ICU admissions for alternative strategies using base case assumptions. Universal decolonization was slightly more expensive and could prevent an additional 35 cases of colonization and 8 cases of infection. We use beta distributions for probabilities, log normal distributions for length of stay and cost, and triangular distributions for risk of post-discharge infection. National burden of invasive methicillin-resistant Staphylococcus aureus infections, United States, Open in a separate window.
Design Cost-effectiveness analysis using a Markov microsimulation model that simulates the natural history of MRSA acquisition and infection.
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Decision analytic models have increasingly been used to evaluate the potential impact of health policy questions, 11 — 13 by comparing the projected outcomes and costs of alternative strategies. Community-acquired MRSA infection was diagnosed in the outpatient setting or within 72 hours of hospital admission. The potential regional impact of contact precaution use in nursing homes to control methicillin-resistant Staphylococcus aureus. It's a strain of staph that's resistant to the broad-spectrum antibiotics commonly used to treat it. Healthcare-Associated Infections - Healthy People. Find out the answers in this section. Costs and outcomes among hemodialysis-dependent patients with methicillin-resistant or methicillin-susceptible Staphylococcus aureus bacteremia.
We also calculated a proportion for how often the strategy of interest was more effective and cost saving compared to the next most expensive strategy. Epidemiology of isolation precautions. Selective use of intranasal mupirocin and chlorhexidine bathing and the incidence of methicillin-resistant Staphylococcus aureus colonization and infection among intensive care unit patients. All other strategies were dominated. The ability of hospitals to invest in prevention efforts may vary depending on their calculated return on investment.