%0 Journal Article %1 keshtgar_impact_2008 %A Keshtgar, M R S %A Khalili, A %A Coen, P G %A Carder, C %A Macrae, B %A Jeanes, A %A Folan, P %A Baker, D %A Wren, M %A Wilson, A P R %D 2008 %J The British Journal of Surgery %K Analysis, Bacteremia, Chain Compliance, Cross Department, Elective, Emergency Handling, Hospital, Humans, Infection Infection, Infections, Methicillin Nose, Patient Polymerase Procedures, Reaction, Resistance, Specimen Staphylococcal Staphylococcus Surgery Surgical Treatment, Wound aureus, {Cost-Benefit} %N 3 %P 381--6 %R 10.1002/bjs.6013 %T Impact of rapid molecular screening for meticillin-resistant Staphylococcus aureus in surgical wards %U http://www.ncbi.nlm.nih.gov/pubmed/18041109 %V 95 %X BACKGROUND: This study aimed to establish the feasibility and cost-effectiveness of rapid molecular screening for hospital-acquired meticillin-resistant Staphylococcus aureus (MRSA) in surgical patients within a teaching hospital. METHODS: In 2006, nasal swabs were obtained before surgery from all patients undergoing elective and emergency procedures, and screened for MRSA using a rapid molecular technique. MRSA-positive patients were started on suppression therapy of mupirocin nasal ointment (2 per cent) and undiluted chlorhexidine gluconate bodywash. RESULTS: A total of 18,810 samples were processed, of which 850 (4.5 per cent) were MRSA positive. In comparison to the annual mean for the preceding 6 years, MRSA bacteraemia fell by 38.5 per cent (P \textless 0.001), and MRSA wound isolates fell by 12.7 per cent (P = 0.031). The reduction in MRSA bacteraemia and wound infection was equivalent to a saving of 3.78 beds per year (276,220 pounds sterling), compared with the annual mean for the preceding 6 years. The cost of screening was 302,500 pounds sterling, making a net loss of 26,280 pounds sterling. Compared with 2005, however, there was a net saving of 545,486 pounds sterling. CONCLUSION: Rapid MRSA screening of all surgical admissions resulted in a significant reduction in staphylococcal bacteraemia during the screening period, although a causal link cannot be established.

@article{keshtgar_impact_2008, abstract = {{BACKGROUND:} This study aimed to establish the feasibility and cost-effectiveness of rapid molecular screening for hospital-acquired meticillin-resistant Staphylococcus aureus {(MRSA)} in surgical patients within a teaching hospital. {METHODS:} In 2006, nasal swabs were obtained before surgery from all patients undergoing elective and emergency procedures, and screened for {MRSA} using a rapid molecular technique. {MRSA-positive} patients were started on suppression therapy of mupirocin nasal ointment (2 per cent) and undiluted chlorhexidine gluconate bodywash. {RESULTS:} A total of 18,810 samples were processed, of which 850 (4.5 per cent) were {MRSA} positive. In comparison to the annual mean for the preceding 6 years, {MRSA} bacteraemia fell by 38.5 per cent {(P} {\textless} 0.001), and {MRSA} wound isolates fell by 12.7 per cent {(P} = 0.031). The reduction in {MRSA} bacteraemia and wound infection was equivalent to a saving of 3.78 beds per year (276,220 pounds sterling), compared with the annual mean for the preceding 6 years. The cost of screening was 302,500 pounds sterling, making a net loss of 26,280 pounds sterling. Compared with 2005, however, there was a net saving of 545,486 pounds sterling. {CONCLUSION:} Rapid {MRSA} screening of all surgical admissions resulted in a significant reduction in staphylococcal bacteraemia during the screening period, although a causal link cannot be established.}, added-at = {2011-03-11T10:05:34.000+0100}, author = {Keshtgar, M R S and Khalili, A and Coen, P G and Carder, C and Macrae, B and Jeanes, A and Folan, P and Baker, D and Wren, M and Wilson, A P R}, biburl = {https://www.bibsonomy.org/bibtex/260b95acf539f44656c23c05aeb71428c/jelias}, doi = {10.1002/bjs.6013}, interhash = {c51b9caa24609903e72ef43c3be6b576}, intrahash = {60b95acf539f44656c23c05aeb71428c}, issn = {1365-2168}, journal = {The British Journal of Surgery}, keywords = {Analysis, Bacteremia, Chain Compliance, Cross Department, Elective, Emergency Handling, Hospital, Humans, Infection Infection, Infections, Methicillin Nose, Patient Polymerase Procedures, Reaction, Resistance, Specimen Staphylococcal Staphylococcus Surgery Surgical Treatment, Wound aureus, {Cost-Benefit}}, month = mar, note = {{PMID:} 18041109}, number = 3, pages = {381--6}, timestamp = {2011-03-11T10:06:43.000+0100}, title = {Impact of rapid molecular screening for meticillin-resistant Staphylococcus aureus in surgical wards}, url = {http://www.ncbi.nlm.nih.gov/pubmed/18041109}, volume = 95, year = 2008 }