The economic value of screening haemodialysis patients for methicillin-resistant Staphylococcus aureus in the USA

B. Y. Lee, Y. Song, S. M. Mcglone, R. R. Bailey, J. M. Feura, J. H.Y. Tai, G. J. Lewis, A. E. Wiringa, K. J. Smith, R. R. Muder, L. H. Harrison, B. Piraino

Research output: Contribution to journalArticle

Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) can cause severe infections in patients undergoing haemodialysis. Routine periodic testing of haemodialysis patients and attempting to decolonize those who test positive may be a strategy to prevent MRSA infections. The economic value of such a strategy has not yet been estimated. We constructed a Markov computer simulation model to evaluate the economic value of employing routine testing (agar-based or PCR) at different MRSA prevalence, spontaneous clearance, costs of decolonization and decolonization success rates, performed every 3, 6 or 12 months. The model showed periodic MRSA surveillance with either test to be cost-effective (incremental cost-effectiveness ratio ≤$50000/quality-adjusted life-year) for all conditions tested. Agar surveillance was dominant (i.e. less costly and more effective) at an MRSA prevalence ≥10% and a decolonization success rate ≥25% for all decolonization treatment costs tested with no spontaneous clearance. PCR surveillance was dominant when the MRSA prevalence was ≥20% and decolonization success rate was ≥75% with no spontaneous clearance. Routine periodic testing and decolonization of haemodialysis patients for MRSA may be a cost-effective strategy over a wide range of MRSA prevalences, decolonization success rates, and testing intervals.

Original languageEnglish (US)
Pages (from-to)1717-1726
Number of pages10
JournalClinical Microbiology and Infection
Volume17
Issue number11
DOIs
StatePublished - Nov 2011

Keywords

  • Cost-effectiveness
  • Economics
  • Haemodialysis
  • Methicillin-resistant Staphylococcus aureus
  • Surveillance

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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  • Cite this

    Lee, B. Y., Song, Y., Mcglone, S. M., Bailey, R. R., Feura, J. M., Tai, J. H. Y., Lewis, G. J., Wiringa, A. E., Smith, K. J., Muder, R. R., Harrison, L. H., & Piraino, B. (2011). The economic value of screening haemodialysis patients for methicillin-resistant Staphylococcus aureus in the USA. Clinical Microbiology and Infection, 17(11), 1717-1726. https://doi.org/10.1111/j.1469-0691.2011.03525.x