%0 Journal Article %1 wassenberg_rapid_2010 %A Wassenberg, M W M %A Kluytmans, J A J W %A Box, A T A %A Bosboom, R W %A Buiting, A G M %A van Elzakker, E P M %A Melchers, W J G %A van Rijen, M M L %A Thijsen, S F T %A Troelstra, A %A Vandenbroucke-Grauls, C M J E %A Visser, C E %A Voss, A %A Wolffs, P F G %A Wulf, M W H %A van Zwet, A A %A de Wit, G A %A Bonten, M J M %D 2010 %J Clinical Microbiology and Infection: The Official Publication of the European Society of Clinical Microbiology and Infectious Diseases %K imported %R 10.1111/j.1469-0691.2010.03210.x %T Rapid screening of methicillin-resistant Staphylococcus aureus (MRSA) using PCR and chromogenic agar: a prospective study to evaluate costs and effects %U http://www.ncbi.nlm.nih.gov/pubmed/20219077 %X Abstract Pre-emptive isolation of suspected MRSA carriers is considered essential in controlling spread of MRSA, but non-colonized patients will be isolated unnecessarily due to a diagnostic delay of 3-5 days with conventional cultures. We determined costs per isolation day avoided and incremental costs of rapid MRSA screening tests when added to conventional screening, but with decisions on isolation measures based on PCR results. A prospective multi-centre study evaluating BD GeneOhm(TM) MRSA PCR (IDI), Xpert MRSA (GeneXpert) and chromogenic agar was performed in 14 Dutch hospitals. Among 1764 patients at risk, MRSA prevalence was 3.3\% (n=59). Duration of isolation was 19.7 and 16.1 hours with IDI and GeneXpert, respectively, and would have been 30.0 and 76.2 hours when based on chromogenic agar and conventional cultures, respectively. Negative predictive values (at a patient level) were 99.5\%, 99.1\% and 99.5\% for IDI, GeneXpert and chromogenic agar, respectively. Numbers of isolation days were reduced by 60\% and 47\% with PCR-based and chromogenic agar-based screening, respectively. Cost per test were euro56.22 for IDI, euro69.62 for GeneXpert, and euro2.08 for chromogenic agar, and additional costs per extra isolation day were euro26.34. Costs per isolation day avoided were euro95.77 (IDI) and euro125.43 (GeneXpert). PCR-based decision making added euro153.64 (IDI) and euro193.84 (GeneXpert) per patient to overall costs and chromogenic testing would have saved euro30.79 per patient. Rapid diagnostic testing safely reduces the number of unnecessary isolation days, but only chromogenic screening, and not PCR-based screening, can be considered cost saving.

@article{wassenberg_rapid_2010, abstract = {Abstract Pre-emptive isolation of suspected {MRSA} carriers is considered essential in controlling spread of {MRSA,} but non-colonized patients will be isolated unnecessarily due to a diagnostic delay of 3-5 days with conventional cultures. We determined costs per isolation day avoided and incremental costs of rapid {MRSA} screening tests when added to conventional screening, but with decisions on isolation measures based on {PCR} results. A prospective multi-centre study evaluating {BD} {GeneOhm(TM)} {MRSA} {PCR} {(IDI),} Xpert {MRSA} {(GeneXpert)} and chromogenic agar was performed in 14 Dutch hospitals. Among 1764 patients at risk, {MRSA} prevalence was 3.3\% (n=59). Duration of isolation was 19.7 and 16.1 hours with {IDI} and {GeneXpert,} respectively, and would have been 30.0 and 76.2 hours when based on chromogenic agar and conventional cultures, respectively. Negative predictive values (at a patient level) were 99.5\%, 99.1\% and 99.5\% for {IDI,} {GeneXpert} and chromogenic agar, respectively. Numbers of isolation days were reduced by 60\% and 47\% with {PCR-based} and chromogenic agar-based screening, respectively. Cost per test were euro56.22 for {IDI,} euro69.62 for {GeneXpert,} and euro2.08 for chromogenic agar, and additional costs per extra isolation day were euro26.34. Costs per isolation day avoided were euro95.77 {(IDI)} and euro125.43 {(GeneXpert).} {PCR-based} decision making added euro153.64 {(IDI)} and euro193.84 {(GeneXpert)} per patient to overall costs and chromogenic testing would have saved euro30.79 per patient. Rapid diagnostic testing safely reduces the number of unnecessary isolation days, but only chromogenic screening, and not {PCR-based} screening, can be considered cost saving.}, added-at = {2011-03-11T10:05:34.000+0100}, author = {Wassenberg, M W M and Kluytmans, J A J W and Box, A T A and Bosboom, R W and Buiting, A G M and van Elzakker, E P M and Melchers, W J G and van Rijen, M M L and Thijsen, S F T and Troelstra, A and {Vandenbroucke-Grauls}, C M J E and Visser, C E and Voss, A and Wolffs, P F G and Wulf, M W H and van Zwet, A A and de Wit, G A and Bonten, M J M}, biburl = {https://www.bibsonomy.org/bibtex/229199a51f6b23354191188000edf01e0/jelias}, doi = {10.1111/j.1469-0691.2010.03210.x}, interhash = {b4b51e9e85605b70e3d5c7dec16b108c}, intrahash = {29199a51f6b23354191188000edf01e0}, issn = {1469-0691}, journal = {Clinical Microbiology and Infection: The Official Publication of the European Society of Clinical Microbiology and Infectious Diseases}, keywords = {imported}, month = mar, note = {{PMID:} 20219077}, shorttitle = {Rapid screening of methicillin-resistant Staphylococcus aureus {(MRSA)} using {PCR} and chromogenic agar}, timestamp = {2011-03-11T10:06:14.000+0100}, title = {Rapid screening of methicillin-resistant Staphylococcus aureus {(MRSA)} using {PCR} and chromogenic agar: a prospective study to evaluate costs and effects}, url = {http://www.ncbi.nlm.nih.gov/pubmed/20219077}, year = 2010 }