scholarly journals 838. Oral Vancomycin Prophylaxis Works!

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S10-S10
Author(s):  
Nicholas W Van Hise ◽  
David Hines ◽  
Vishal Didwania ◽  
David Beezhold ◽  
Vishnu Chundi ◽  
...  
Keyword(s):  
High Risk ◽  
Infection Control ◽  
Predictive Value ◽  
Antibiotic Stewardship ◽  
Assessment Tool ◽  
Pay For Performance ◽  
Risk Groups ◽  
Control Measures ◽  
Urban Hospital ◽  
Oral Vancomycin

Abstract Background Clostridium difficile infections (CDI) cause approximately 500,000 cases a year with an estimated cost that exceeds $4.8 billion. Despite interventions that addressed environmental disinfection, antibiotic stewardship, and infection control, many institutions continue to have a significant burden of disease. Public reporting and “pay for performance” have increased the impetus for better control of CDI. We describe the use of an unpublished scoring system to assess the risk of CDI with subsequent use of OVP to prevent exsporulation and infection in high-risk groups. Methods A large urban hospital in the Chicago area of approximately 400 beds, after following recommended guidelines for prevention of C. difficile, instituted an assessment tool to predict the risk of developing C. difficile infection.This is an observational, cohort study reviewing the pre- and post-implementation of OVP (oral Vancomycin prophylaxis) in hospitalized patients. From January 2017 to December 2017, eligible patients were assessed for risk of C. difficile. The intervention period, from January 2018 to December 2018, we prospectively gave eligible patients oral vancomycin (OVP) 125 mg twice daily if the risk score was 13 or above. No changes in environmental cleaning, antimicrobial stewardship, or restriction of testing were instituted during the periods of enrollment. The analysis was approved by the institutional review board. Results In 2017, 82 patients had a score of 13 or over. Of the 82 patients, 72 (87.8%) developed CDI. In 2018, 62 eligible patients had a score of 13 or over and were given OVP. Of the 62 patients, 5 (8%) developed CDI. The relative risk comparing C. difficile in ≥13 vs. <13 patients (RR = 19.2652; 95% CI = 7.3656, 50.3899). The tool is associated with a specificity of 88.54% and sensitivity of 94.67%, along with a negative predictive value of 95.51% and positive predictive value of 86.59%. Fisher’s exact test was performed between OVP and no OVP in relation to the development of CDI in high-risk patients (P < 0.01). VRE rates reported on the antibiogram remained consistent throughout the study period. No significant differences in baseline characteristics were noted. Conclusion In institutions where appropriate infection control measures and antibiotic stewardship have been implemented, the use of a prediction tool to guide OVP is effective in preventing C. difficile. Disclosures All Authors: No reported Disclosures.

Identifying children at high risk for infection-related decompensation using a predictive emergency department-based electronic assessment tool

Diagnosis ◽  
2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Robert J. Sepanski ◽  
Arno L. Zaritsky ◽  
Sandip A. Godambe
Keyword(s):  
Emergency Department ◽  
High Risk ◽  
Positive Predictive Value ◽  
Firing Rate ◽  
Predictive Value ◽  
Assessment Tool ◽  
Predictive Tool ◽  
High Severity ◽  
Electronic Assessment ◽  
Ed Visits

AbstractObjectivesElectronic alert systems to identify potential sepsis in children presenting to the emergency department (ED) often either alert too frequently or fail to detect earlier stages of decompensation where timely treatment might prevent serious outcomes.MethodsWe created a predictive tool that continuously monitors our hospital’s electronic health record during ED visits. The tool incorporates new standards for normal/abnormal vital signs based on data from ∼1.2 million children at 169 hospitals. Eighty-two gold standard (GS) sepsis cases arising within 48 h were identified through retrospective chart review of cases sampled from 35,586 ED visits during 2012 and 2014–2015. An additional 1,027 cases with high severity of illness (SOI) based on 3 M’s All Patient Refined – Diagnosis-Related Groups (APR-DRG) were identified from these and 26,026 additional visits during 2017. An iterative process assigned weights to main factors and interactions significantly associated with GS cases, creating an overall “score” that maximized the sensitivity for GS cases and positive predictive value for high SOI outcomes.ResultsTool implementation began August 2017; subsequent improvements resulted in 77% sensitivity for identifying GS sepsis within 48 h, 22.5% positive predictive value for major/extreme SOI outcomes, and 2% overall firing rate of ED patients. The incidence of high-severity outcomes increased rapidly with tool score. Admitted alert positive patients were hospitalized nearly twice as long as alert negative patients.ConclusionsOur ED-based electronic tool combines high sensitivity in predicting GS sepsis, high predictive value for physiologic decompensation, and a low firing rate. The tool can help optimize critical treatments for these high-risk children.

scholarly journals The interplay of SARS-CoV-2 and Clostridioides difficile infection

2021 ◽  
Vol 16 (6) ◽  
pp. 439-443
Author(s):  
Sahil Khanna ◽  
Colleen S Kraft
Keyword(s):  
High Risk ◽  
Infection Control ◽  
Gastrointestinal Symptoms ◽  
Control Measures ◽  
Antibiotic Exposure ◽  
Hospital Acquired Infections ◽  
Infection Control Measures ◽  
Clostridioides Difficile ◽  
Clostridioides Difficile Infection ◽  
Hospital Acquired

The COVID-19 pandemic has changed the way we practice medicine and lead our lives. In addition to pulmonary symptoms; COVID-19 as a syndrome has multisystemic involvement including frequent gastrointestinal symptoms such as diarrhea. Due to microbiome alterations with COVID-19 and frequent antibiotic exposure, COVID-19 can be complicated by Clostridioides difficile infection. Co-infection with these two can be associated with a high risk of complications. Infection control measures in hospitals is enhanced due to the COVID-19 pandemic which in turn appears to reduce the incidence of hospital-acquired infections such as C. difficile infection. Another implication of COVID-19 and its potential transmissibility by stool is microbiome-based therapies. Potential stool donors should be screened COVID-19 symptoms and be tested for COVID-19.

Direct costs and clinical impact of adenovirus genotype 8 conjunctivitis outbreak in a neonatology unit

2020 ◽  
pp. 1-7
Author(s):  
María Florencia Angueyra ◽  
Débora Natalia Marcone ◽  
Florencia Escarrá ◽  
Noelia Soledad Reyes ◽  
Yamile Rubies ◽  
...  
Keyword(s):  
High Risk ◽  
Infection Control ◽  
Median Duration ◽  
Tertiary Care ◽  
Productivity Loss ◽  
High Risk Pregnancy ◽  
Control Measures ◽  
Viral Spread ◽  
Infection Control Measures ◽  
Risk Pregnancy

Abstract Objective: To report a conjunctivitis outbreak in a neonatology intensive care unit (NICU) and determine the associated economic impact. Design: Prospective observational study. Setting: Centro de Educación Médica e Investigaciones Clínicas (CEMIC) University Hospital, a private, tertiary-care healthcare institution in Buenos Aires, Argentina. Participants: The study included 52 NICU neonates and 59 NICU-related healthcare workers (HCWs) from CEMIC hospital. Methods: Neonates and HCWs were swabbed for real-time polymerase chain reaction (PCR) testing, viral culture, and typing by sequencing. Infection control measures, structural and logistic changes were implemented. Billing records were analyzed to determine costs. Results: From January 30 to April 28, 2018, 52 neonates were hospitalized in the NICU. Among them, 14 of 52 (21%) had bilateral conjunctivitis with pseudomembranes. Symptomatic neonates and HCWs were HAdV-D8 positive. Ophthalmological symptoms had a median duration of 18 days (IQR, 13–24.5). PCR positivity and infectious range had a median duration of 18.5 days. As part of containment measures, the NICU and the high-risk pregnancy unit were closed to new patients. The NICU was divided into 2 areas for symptomatic and asymptomatic patients; a new room was assigned for the general nursery, and all deliveries from the high-risk pregnancy unit were redirected to other hospitals. The outbreak cost the hospital US$205,000: implementation of a new nursery room and extra salaries cost US$30,350 and estimated productivity loss during 1 month cost US$175,000. Conclusions: Laboratory diagnosis confirmed the cause of this outbreak as HAdV-D8. The immediate adoption and reinforcement of rigorous infection control measures limited the nosocomial viral spread. This outbreak represented a serious institutional problem, causing morbidity, significant economic loss, and absenteeism.

Transmission and control in an institutional pandemic influenza A(H1N1) 2009 outbreak

2011 ◽  
Vol 140 (6) ◽  
pp. 1102-1110 ◽  
Author(s):  
N. ARINAMINPATHY ◽  
N. RAPHAELY ◽  
L. SALDANA ◽  
C. HODGEKISS ◽  
J. DANDRIDGE ◽  
...  
Keyword(s):  
High Risk ◽  
Infection Control ◽  
Pandemic Influenza ◽  
Summer School ◽  
Influenza A ◽  
Control Measures ◽  
Infection Control Measures ◽  
Influenza A H1n1 ◽  
Hygiene Measures ◽  
The Impact

SUMMARYA pandemic influenza A(H1N1) 2009 outbreak in a summer school affected 117/276 (42%) students. Residential social contact was associated with risk of infection, and there was no evidence for transmission associated with the classroom setting. Although the summer school had new admissions each week, which provided susceptible students the outbreak was controlled using routine infection control measures (isolation of cases, basic hygiene measures and avoidance of particularly high-risk social events) and prompt treatment of cases. This was in the absence of chemoprophylaxis or vaccination and without altering the basic educational activities of the school. Modelling of the outbreak allowed estimation of the impact of interventions on transmission. These models and follow-up surveillance supported the effectiveness of routine infection control measures to stop the spread of influenza even in this high-risk setting for transmission.

An evaluation of the performance of OraQuick® ADVANCE Rapid HIV-1/2 Test in a high-risk population attending genitourinary medicine clinics in East London, UK

2008 ◽  
Vol 19 (10) ◽  
pp. 665-667 ◽  
Author(s):  
J Zelin ◽  
N Garrett ◽  
J Saunders ◽  
F Warburton ◽  
J Anderson ◽  
...  
Keyword(s):  
High Risk ◽  
Test Performance ◽  
Predictive Value ◽  
Risk Groups ◽  
Antibody Detection ◽  
High Risk Population ◽  
Antibody Testing ◽  
Observer Error ◽  
The Uk ◽  
Hiv 1

To date, no data have been published on the use of OraQuick® ADVANCE Rapid HIV-1/2 Test (OraQuick) in the UK. We report preliminary findings of an ongoing evaluation of OraQuick in UK genitourinary (GU) medicine clinics. A total of 820 samples from patients in high-risk groups for HIV were tested with OraQuick and results were compared with standard HIV antibody testing. HIV prevalence (enzyme immunoassay [EIA]) was 5.73%, sensitivity of OraQuick was 93.64% (95% CI 82.46–98.66%), specificity 99.87% (99.28–100%), positive predictive value 97.78% (88.27–99.94%) and negative predictive value 99.61% (98.87–99.92%). This includes three false-negatives considered to be due to observer error and now rectified by further training. This has increased test sensitivity to 100%. Our observed test performance of OraQuick compares well with EIA and with other rapid tests. We believe that simple, non-invasive antibody detection tests such as OraQuick can increase HIV testing and diagnosis in UK GU medicine and community settings.

scholarly journals A Rapid Heparin Antibody Detection Assay Performs Better Than 4T's Score in Predicting HIT Diagnosis: A Single Community Medical Center Retrospective Analysis

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 1457-1457 ◽  
Author(s):  
Srikant Nannapaneni ◽  
Ishan Malhotra ◽  
Michael Simon ◽  
Phone Oo ◽  
Trishala Meghal ◽  
...  
Keyword(s):  
High Risk ◽  
Roc Curve ◽  
Predictive Value ◽  
Risk Groups ◽  
Low Risk ◽  
Receiver Operating Characteristics ◽  
Operating Characteristics ◽  
Test Result ◽  
4T Score ◽  
Receiver Operating

Abstract Introduction: The diagnosis of heparin induced thrombocytopenia (HIT) and thrombosis (HITT) is challenging due to poor availability of the gold standard serotonin releasing assay (SRA) and suboptimal positive predictive value from clinical scoring models such as 4T score. A common algorithm used for diagnosing HIT is: 4T's pretest probability score estimation in cases suspected of HIT; followed by HIT antibody test in the intermediate to high risk groups; followed by confirmation with SRA test in HIT antibody positive patients. Since 2011, a Particle Immune-Filtration Assay (PIFA) Heparin/Platelet Factor 4 Rapid Assay (HPF4-RA) (Akers Bioscience, Inc, Thorofare, NJ) became available in our medical center and test results were available on the same day. We observed that HPF4-RA test was being routinely ordered along with SRA test at the same time. We performed this retrospective analysis to evaluate and compare the predictive performance for SRA positive HIT diagnosis using 4T score or HPF4-RA. We applied a regression analysis model, to calculate area under receiver operating characteristics (ROC) curve. Methods: A list of all consecutive patients who had HIT antibody test and/or SRA test performed between January 2010 and June 2013 was obtained, which consisted of 402 patients. Patients with duplication of tests were deleted from analysis. 283 patients had results reported for both HPF4-RA (positive in n=42, negative in n=241) and SRA tests (positive in n=16 and negative in n=267); and these results were used for calculation of HPF4-RA prediction model. Two patients had HPF4-RA negative result but SRA positive test result. 4T's scores were calculated for 125 patients, consisting of all HPF4-RA positive patients (n=42), and patients randomly selected from the total HPF4-RA negative pool (n=83). Electronic medical records were reviewed for temporal trend of platelet counts, diagnosis, medication use, Doppler tests and competing causes of thrombocytopenia. Persons calculating the 4T's score were blinded to the laboratory test results. Results: Stratification of the patients with 4T's score analysis (n=125) revealed that the distribution of SRA positive patients (n=16) was 31.3% (n=5) in low risk, 31.3% (n=5) in intermediate risk, and 37.5% (n=6) in high risk groups; while the distribution of SRA negative patients (n=109) was 45.9% (n=50) in low risk, 43.1% (n=47) in intermediate risk and 11.0% (n=12) in high risk groups. The area under receiver operating characteristics (ROC) curve for 4T score as a continuous variable to predict SRA positive HIT was 0.659 (95% CI 0.516 - 0.802; p = 0.041), and the area under ROC curve for HPF4-RA to predict SRA positive HIT was 0.818 ( 95% CI 0.712 - 0.924; p = 0.00) (Figure 1). HPF4-RA test also showed better overall prediction parameters for HIT as shown in Table 1. A combination of HIT HPF4-RA positive result and a 4T score ≥ 4 did not increase the area under ROC curve for prediction of SRA positive HIT. Abstract 1457. Table1: Predictive performance of 4T's score and HPF4-RA for HIT (defined by positive SRA) Sensitivity (95% CI) Specificity (95% CI) PPV (95% CI) NPV (95% CI) Number of patients (%) 4T's score ≤ 3 (Low Risk) 0.31 (0.11 – 0.59) 0.72 (0.64 - 0.79) 0.11 (0.03 - 0.23) 0.91 (0.84 - 0.95) 56 (44.8) 4T's score ≥ 4 (Intermediate and High Risk) 0.69 (0.41-0.89) 0.39 (0.29 - 0.48) 0.14 (0.72 - 0.24) 0.89 (0.77 - 0.96) 69 (55.2) 4T's score ≥ 6 (High Risk) 0.37 (0.15-0.65) 0.82 (0.74 - 0.89) 0.24 (0.09 - 0.45) 0.90 (0.82 - 0.95) 17 (13.6) HPF4-RA Test 0.88 (0.62-0.98) 0.86 (0.81- 0.90) 0.26 (0.16 - 0.41) 0.99 (0.96 - 0.99) 283 PPV: Positive Predictive Value. NPV: Negative Predictive Value Figure 1: Receiver Operating Characteristics (ROC) curve of the 4T's score and HPF4-RA test result for determining the presence of HIT (defined by positive SRA). Figure 1:. Receiver Operating Characteristics (ROC) curve of the 4T's score and HPF4-RA test result for determining the presence of HIT (defined by positive SRA). Conclusions: Both 4T's score and HPF4-RA testing predict SRA positive HIT more than chance; however HPF4-RA testing predicts SRA positive HIT better than 4T's scores with higher sensitivity, specificity and NPV. This result challenges the pretesting algorithm for selecting patients for confirmatory SRA testing to diagnose HIT. Instead of using 4T's score as a screening tool for selecting patients for HPF4 antibody testing; rapid HPF4 antibody assays when available, should be considered as upfront screening tool and positive results considered for confirmatory SRA testing for diagnosis of HIT. Further studies are warranted to confirm this data. Disclosures No relevant conflicts of interest to declare.

scholarly journals Identification and Validation of m6A-Related lncRNA Signature as Potential Predictive Biomarkers in Breast Cancer

2021 ◽  
Vol 11 ◽  
Author(s):  
Wenchang Lv ◽  
Yichen Wang ◽  
Chongru Zhao ◽  
Yufang Tan ◽  
Mingchen Xiong ◽  
...  
Keyword(s):  
Breast Cancer ◽  
High Risk ◽  
Risk Score ◽  
Assessment Tool ◽  
Cox Regression ◽  
Screening Method ◽  
Predictive Biomarkers ◽  
Risk Groups ◽  
Low Risk ◽  
Main Challenge

The metastasis and poor prognosis are still regarded as the main challenge in the clinical treatment of breast cancer (BC). Both N6-methyladenosine (m6A) modification and lncRNAs play vital roles in the carcinogenesis and evolvement of BC. Considering the unknown association of m6A and lncRNAs in BC, this study therefore aims to discern m6A-related lncRNAs and explore their prognostic value in BC patients. Firstly, a total of 6 m6A-related lncRNAs were screened from TCGA database and accordingly constructed a prognostic-predicting model. The BC patients were then divided into high-risk and low-risk groups dependent on the median cutoff of risk score based on this model. Then, the predictive value of this model was validated by the analyses of cox regression, Kaplan-Meier curve, ROC curve, and the biological differences in the two groups were validated by PCA, KEGG, GSEA, immune status as well as in vitro assay. Finally, we accordingly constructed a risk prognostic model based on the 6 identified m6A-related lncRNAs, including Z68871.1, AL122010.1, OTUD6B-AS1, AC090948.3, AL138724.1, EGOT. Interestingly, the BC patients were divided into the low-risk and high-risk groups with different prognoses according to the risk score. Notably, the risk score of the model was an excellent independent prognostic factor. In the clinical sample validation, m6A regulatory proteins were differentially expressed in patients with different risks, and the markers of tumor-associated macrophages and m6A regulators were co-localized in high-risk BC tissues. This well-validated risk assessment tool based on the repertoire of these m6A-related genes and m6A-related lncRNAs, is of highly prognosis-predicting ability, and might provide a supplemental screening method for precisely judging BC prognosis.

Control of Vancomycin-Resistant Enterococci in the Neonatal Intensive Care Unit

2005 ◽  
Vol 26 (7) ◽  
pp. 646-649 ◽  
Author(s):  
Nalini Singh ◽  
Marie-Michèle Léger ◽  
Joyce Campbell ◽  
Billie Short ◽  
Joseph M. Campos
Keyword(s):  
High Risk ◽  
Infection Control ◽  
Dna Fingerprinting ◽  
Active Surveillance ◽  
Genetic Relatedness ◽  
Control Measures ◽  
Infection Control Measures ◽  
Vancomycin Resistant Enterococci ◽  
Surveillance Cultures ◽  
Vancomycin Resistant

AbstractBackground and Objective:Multidrug-resistant organisms (MDROs), such as vancomycin-resistant enterococci (VRE), cause serious infections, especially among high-risk patients in NICUs. When VRE was introduced and transmitted in our NICU despite recommended infection control practices, we instituted active surveillance cultures to determine their efficacy in detecting and controlling spread of VRE among high-risk infants.Methods:Active surveillance cultures, other infection control measures, and a mandatory in-service education module on preventing MDRO transmission were implemented. Cultures were performed on NICU admission and then weekly during their stay. Molecular DNA fingerprinting of VRE isolates facilitated targeting efforts to eliminate clonal spread of VRE. Repetitive sequence PCR (rep-PCR)-based DNA fingerprinting was used to compare isolates recovered from patients with VRE infection or colonization. Environmental VRE cultures were performed around VRE-colonized or -infected patients. DNA fingerprints were prepared from the products of rep-PCR amplification and analyzed using software to determine strain genetic relatedness.Results:Active surveillance cultures identified 65 patients with VRE colonization or infection among 1,820 admitted to the NICU. Rep-PCR performed on 60 VRE isolates identified 3 clusters. Cluster 1 included isolates from 21 patients and 4 isolates from the environment of the index patient. Clusters 2 and 3 included isolates from 23 and 3 patients, respectively. Similarity coefficients among the members of each cluster were 95% or greater.Conclusions:Control of transmission of multi-clonal VRE strains was achieved. Active surveillance cultures, together with implementation of other infection control measures, combined with rep-PCR DNA fingerprinting were instrumental in controlling VRE transmission in our NICU. (Infect Control Hosp Epidemiol 2005;26:646-649)

scholarly journals 1277Reasons for quarantine and positivity rate among quarantined Health Care Workers (HCWs) in North India

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Naveen Prashar ◽  
Rahuldeep Singh ◽  
Ritin Mohindra ◽  
Vikas Suri ◽  
Ashish Bhalla ◽  
...  
Keyword(s):  
Risk Assessment ◽  
High Risk ◽  
Assessment Tool ◽  
Risk Groups ◽  
Low Risk ◽  
North India ◽  
Risk Exposure ◽  
P Value ◽  
Risk Category ◽  
Personal Protection Equipment

Abstract Background WHO has declared the COVID-19 as Pandemic on 11th March, 2020. It is important to break the chain of transmission by quarantining the persons with high-risk exposure. Understanding the reasons for quarantine will help in reducing the exposures and thus reducing the chances of quarantine. Methods A validated risk assessment tool based on National Centre for Disease Control guidelines was used for the risk assessment of HCWs. The forms of HCWs who underwent risk assessment between April-November, 2020 were analyzed for reasons of quarantine. The positivity rates among high-risk and low-risk groups were compared. Results Out of 1414 HCWs who were assessed, 345 were categorized as high-risk exposure and were quarantined. The most common reasons for quarantine were performance of aerosol generating procedure without recommended personal protection equipment (PPE) (34%), exposure to COVID-19 positive patient without mask for more than 20 minutes at the distance less than 1 m (30%) and having food/tea together (27%). The positivity rate was 8.4% among high-risk and 1.9% among low-risk exposure group (p-value: &lt;0.001). The positivity among low risk category was more in the second half (19/466; 4.1%) as compared to first half (1/603; 0.2%) of the study period. This might be due to exposure from non-hospital sources as second half coincides with first wave of the pandemic. Conclusion Not using recommended PPE and having tea/food breaks together were the most common reasons for quarantine. Key messages Strict enforcement of recommended PPE and scattered tea and food breaks can reduce high-risk exposures.

Screening High-Risk Patients for Methicillin-ResistantStaphylococcus Aureuson Admission to the Hospital Is It Cost Effective?

1999 ◽  
Vol 20 (7) ◽  
pp. 473-477 ◽  
Author(s):  
Giuseppe Papia ◽  
Marie Louie ◽  
Arnold Tralla ◽  
Claudette Johnson ◽  
Veronica Collins ◽  
...  
Keyword(s):  
Nursing Home ◽  
High Risk ◽  
Infection Control ◽  
Control Measures ◽  
Care Hospital ◽  
High Risk Patients ◽  
Infection Control Measures ◽  
Risk Patients ◽  
Nursing Costs ◽  
Mrsa Colonization

Objectives:To determine the cost-effectiveness of a policy of screening high-risk patients for methicillin-resistantStaphylococcus aureus(MRSA) colonization on admission to hospital.Setting:980-bed university-affiliated tertiary-care hospital.Patients:Between June 1996 and May 1997, patients directly transferred from another hospital or nursing home, or who had been hospitalized in the previous 3 months, were screened for MRSA within 72 hours of hospital admission.Design:Nasal, perineal, and wound swabs were obtained for MRSA screening using standard laboratory methods. Laboratory and nursing costs associated with screening patients for MRSA on admission to hospital were calculated. The costs associated with the implementation of recommended infection control measures for patients with MRSA also were determined.Results:3,673 specimens were obtained from 1,743 patients. MRSA was found on admission in 23 patients (1.3%), representing 36% of the 64 patients with MRSA identified in the hospital during the year. MRSA-colonized patients were more likely to have been transferred from a nursing home (odds ratio [OR], 6.4;P=.04) or to have had a previous history of MRSA colonization (OR, 13.1;P=.05). Laboratory and nursing costs were found to be $8.34 per specimen, for a total cost of $30,632 during the year. The average cost of implementing recommended infection control measures for patients colonized with MRSA was approximately $5,235 per patient.Conclusion:If early identification of MRSA in colonized patients prevents nosocomial transmission of the organism to as few as six new patients, the screening program would save money.

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