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A study of the efficacy and cost-effectiveness of MRSA screening and monitoring on surgical wards using a new, rapid molecular test (EMMS)

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Hardy, Catherine J., Szczepura, Ala, Davies , Ruth, Bradbury, Andrew, Stallard, Nigel, Gossain, Savita, Walley, Paul and Hawkey, Peter M.. (2007) A study of the efficacy and cost-effectiveness of MRSA screening and monitoring on surgical wards using a new, rapid molecular test (EMMS). BMC Health Services Research, Vol.7 (No.160). ISSN 1472-6963

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Official URL: http://dx.doi.org/10.1186/1472-6963-7-160

Abstract

Background: MRSA is a significant contributor to prolonged hospital stay, poor clinical outcome and increased healthcare costs amongst surgical patients. A PCR test has been developed for rapid detection of MRSA in nasal swabs. The aims of this study are (1) to estimate the effectiveness of screening using this rapid PCR tests vs culture in reducing MRSA cross-infection rates; (2) to compare the cost of each testing strategy, including subsequent health care costs; and (3) to model different policies for the early identification and control of MRSA infection in surgical patients. Methods/Design: The study is a prospective two-period cross-over study set in 7 surgical wards covering different surgical specialities. A total of 10,000 patients > 18 years will be tested over 16 months. The only difference between the two study periods is the method used for the detection of MRSA in each ward (rapid v conventional culture), with all other infection control practices remaining consistent between the arms. The study has been designed to complement routine practice in the NHS. Outcomes are MRSA cross-infection rates (primary outcome) and need for antibiotic therapy and MRSA-related morbidity. Parallel economic and modelling studies are being conducted to aid in the interpretation of the results and to evaluate the cost-effectiveness of the rapid PCR screening strategy. Discussion: This paper highlights the design, methods and operational aspects of a study evaluating rapid MRSA screening in the surgical ward setting.

Item Type:	Journal Article
Subjects:	R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions:	Faculty of Medicine > Warwick Medical School > Clinical Sciences Research Institute (CSRI) Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Nosocomial infections, Infection control, Medical screening
Journal or Publication Title:	BMC Health Services Research
Publisher:	Biomed central
ISSN:	1472-6963
Date:	3 October 2007
Volume:	Vol.7
Number:	No.160
Identification Number:	10.1186/1472-6963-7-160
Status:	Peer Reviewed
Access rights to Published version:	Open Access
Description:	Final version (published as open access)
Funder:	Great Britain. Dept. of Health (DoH)
Grant number:	0190014
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URI:	http://wrap.warwick.ac.uk/id/eprint/131