https://scholars.lib.ntu.edu.tw/handle/123456789/479814
標題: | Impact of active screening for methicillin-resistant Staphylococcus aureus (MRSA) and decolonization on MRSA infections, mortality and medical cost: A quasi-experimental study in surgical intensive care unit | 作者: | Lee Y.-J. Chen J.-Z. Lin H.-C. Liu H.-Y. Lin S.-Y. HSIEN-HO LIN CHI-TAI FANG PO-REN HSUEH |
公開日期: | 2015 | 卷: | 19 | 期: | 1 | 起(迄)頁: | 143 | 來源出版物: | Critical Care | 摘要: | Introduction: Methicillin-resistant Staphylococcus aureus (MRSA) is a leading pathogen of healthcare-associated infections in intensive care units (ICUs). Prior studies have shown that decolonization of MRSA carriers is an effective method to reduce MRSA infections in ICU patients. However, there is currently a lack of data on its effect on mortality and medical cost. Methods: Using a quasi-experimental, interrupted time-series design with re-introduction of intervention, we evaluated the impact of active screening and decolonization on MRSA infections, mortality and medical costs in the surgical ICU of a university hospital in Taiwan. Regression models were used to adjust for effects of confounding variables. Results: MRSA infection rate decreased from 3.58 (baseline) to 0.42? (intervention period) (P <0.05), re-surged to 2.21? (interruption period) and decreased to 0.18? (re-introduction of intervention period) (P <0.05). Patients admitted to the surgical ICU during the intervention periods had a lower in-hospital mortality (13.5% (155 out of 1,147) versus 16.6% (203 out of 1,226), P = 0.038). After adjusting for effects of confounding variables, the active screening and decolonization program was independently associated with a decrease in in-hospital MRSA infections (adjusted odds ratio: 0.3; 95% CI: 0.1 to 0.8) and 90-day mortality (adjusted hazard ratio: 0.8; 95% CI: 0.7 to 0.99). Cost analysis showed that $22 medical costs can be saved for every $1 spent on the intervention. Conclusions: Active screening for MRSA and decolonization in ICU settings is associated with a decrease in MRSA infections, mortality and medical cost. ? Lee et al.; licensee BioMed Central Ltd. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/479814 | ISSN: | 1364-8535 | DOI: | 10.1186/s13054-015-0876-y | SDG/關鍵字: | chlorhexidine gluconate; pseudomonic acid; antiinfective agent; chlorhexidine; chlorhexidine gluconate; pseudomonic acid; topical antiinfective agent; aged; Article; clinical evaluation; confidence interval; confounding variable; correlation analysis; cost benefit analysis; cost control; female; hazard ratio; health care cost; healthcare associated infection; human; infection control; intensive care unit; length of stay; major clinical study; male; methicillin resistant Staphylococcus aureus; methicillin resistant Staphylococcus aureus infection; microbiological examination; mortality; nose smear; prevalence; priority journal; quasi experimental study; regression analysis; risk factor; screening; statistical analysis; surgical ward; Taiwan; treatment outcome; university hospital; analogs and derivatives; cross infection; disinfection; economics; epidemiology; heterozygote; hospital mortality; isolation and purification; methicillin resistant Staphylococcus aureus; microbiology; middle aged; mortality; nose cavity; Staphylococcal Infections; transmission; Aged; Anti-Bacterial Agents; Anti-Infective Agents, Local; Carrier State; Chlorhexidine; Cross Infection; Disinfection; Female; Hospital Mortality; Humans; Infection Control; Intensive Care Units; Male; Methicillin-Resistant Staphylococcus aureus; Middle Aged; Mupirocin; Nasal Cavity; Staphylococcal Infections; Taiwan |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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