Hardy, K. (Katherine), Szczepura, Ala, Davies, Ruth, Bradbury, Andrew, Stallard, Nigel, Gossain, Savita, Walley, Paul and Hawkey, P. M. (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). doi:10.1186/1472-6963-7-160 ISSN 1472-6963.

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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 Science, Engineering and Medicine > 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
Official Date:	3 October 2007
Dates:	Date Event 3 October 2007 Published
Volume:	Vol.7
Number:	No.160
DOI:	10.1186/1472-6963-7-160
Status:	Peer Reviewed
Access rights to Published version:	Open Access (Creative Commons)
Description:	Final version (published as open access)
Funder:	Great Britain. Dept. of Health (DoH)
Grant number:	0190014

Data sourced from Thomson Reuters' Web of Knowledge

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