Conducting twice-yearly mass nasal screenings on hemodialysis patients who are at high risk for methicillin-resistant Staphylococcus aureus in an area of low MRSA endemicity may not be cost-effective, according to research published in Infection Control & Hospital Epidemiology.
Researchers analyzed the results of twice-yearly MRSA prevalence studies conducted in the hemodialysis unit of a 950-bed tertiary care hospital from Jan. 1, 2004, through Dec. 31, 2013.
All total, there were 20 mass screenings during the 10-year study and 415 patients participated in at least one screening, with an average of 4.5 screenings per patient. The researchers found only 15 of the 415 (3.6 percent) screened patients were found to be MRSA carriers.
Additionally, the first mass screening in 2004 yielded the highest percentage of MRSA (6 percent), seven subsequent screenings revealed new MRSA carriers, four screenings confirmed previously known carriers and eight remained negative. During the study, none of the carriers developed MRSA.
To screen and isolate patients costs a total of $93,930, whereas the total cost of an alternative strategy that excluded mass screenings would be equivalent to the cost of isolation of index cases and contact tracing, roughly $5,382.
"In an area of low MRSA endemicity, regular nasal screenings of a high-risk population yielded a low rate of MRSA carriers," concluded the study authors. "Twice-yearly MRSA screening of dialysis patients is unlikely to be cost-effective if MRSA prevalence is low."
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