エンドミックなメチチリン耐性黄金球菌 (Staphylococcus aureus) の制御:集中治療室での費用対効果分析
C Chaix1, I Durand-Zaleski, C Alberti
1Department of Public Health, Créteil, France.
JAMA
|November 24, 1999
まとめ
検診と隔離を含む,メチシリン耐性黄金球菌 (MRSA) 制御プログラムの実施は,固有の集中治療室 (ICU) で費用対効果的です. この戦略は,MRSA感染と関連する医療費を削減することにより,大きな利益をもたらします.
科学分野:
- 感染症 感染症は感染症です.
- 病院疫学 病院疫学について
- 健康経済学 医療経済学
背景:
- エンドミックなメチチリン耐性黄色のスタフィロコーカス (MRSA) は,病院における課題となっています.
- コストと限られた利益に関する懸念は,MRSA制御プログラムの実施を妨げています.
研究 の 目的:
- エンドミックな病院環境におけるMRSA制御プログラムの経済的コストと利益を比較する.
- MRSA媒介者の選択的スクリーニングと隔離の費用対効果を評価する.
主な方法:
- フランスの大学病院の医療集中治療室 (ICU) で,症例対照研究が行われました.
- MRSA感染のコストは,制御プログラム (スクリーニングと隔離) のコストと比較されました.
- 感受性分析では,さまざまな伝播率,感染率,滞在期間などを調査した.
主要な成果:
- MRSA感染の平均コストは9,275ドルであり,対照プログラムのコストは患者当たり340ドルから1,480ドルであった.
- MRSA感染率の14%の減少は,制御プログラムを有益なものにした.
- この戦略は,ICUの入院時にMRSAの運搬の流行率が1%から7%の間で支配的であった.
結論:
- 選択的スクリーニングとICU入院時にMRSAキャリアの隔離は,固有の環境では有益です.
- このアプローチは,孤立化戦略がないよりも費用対効果が高くなります.
- この発見は,病院におけるMRSA制御プログラムの実施を支えるものである.
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