A systematic review on prevention of Methicillin-Resistant Staphylococcus aureus infection by pre-admission screening

The cost effectiveness and practicality

Nurul Izzati Binti Abdul Halim, Nor Azlina Binti A. Rahman, Noraziah Mohamad Zin, Mohd Shukri Bin Baba, Nor Iza A. Rahman, Mainul Haque

Research output: Contribution to journalReview article

Abstract

Background: Methicillin Resistant Staphylococcus aureus (MRSA) is a common source of nosocomial infection, which is spreading through the community and hospitals across the countries. The performance of screening program really needs major effort related to laboratory capacity and ethical consideration, among other costly components. Significant literature research was conducted to review the cost, effectiveness and practicality of different methods of pre-admission MRSA screening in the hospital setting. A systematic literature review was conducted with search strategy using the PubMed Medline, Scopus and the Science Direct databases. The relevant data was abstracted from all studies based on various countries which in line with the finalized eligibility criteria. Results: PCR method was reported to have high sensitivity with low turnaround time as compared to culture method. A review of selected studies found the increasing annual costs of screening from standard culture, chromogenic agar to rapid PCR. In the meantime, other studies reported the total costs for labor and materials was lower for rapid PCR screening compared to culture methods. The culturing method offers a high level of variability due to time consumption and additional costs. Whereas PCR was reported as advantageous in term of saving time to identify MRSA positive patients, which involved isolation, thus increase the effectiveness of screening programs. It can pick up false negative results by conventional methods in the early condition of disease. Conclusion: Most studies verified that PCR is the most accurate method for detection of MRSA with Xpert MRSA having the best performance. Otherwise, oxacillin agar screen was revealed as a good alternative method to PCR. Targeted screening on high risk patients using rapid PCR may be the best choice to be implemented, in order to balance the economic and practicality of screening. We recommend that further clinical studies should be done to provide a sharp evidence of MRSA screening.

Original languageEnglish
Pages (from-to)1-19
Number of pages19
JournalSystematic Reviews in Pharmacy
Volume7
Issue number1
DOIs
Publication statusPublished - 2016

Fingerprint

Methicillin-Resistant Staphylococcus aureus
Cost-Benefit Analysis
Polymerase Chain Reaction
Infection
Costs and Cost Analysis
Agar
Oxacillin
Community Hospital
Program Evaluation
Cross Infection
PubMed
Economics
Databases
Research

Keywords

  • Cost-Effectiveness
  • MRSA
  • Pre-Admission
  • Prevention
  • Screening

ASJC Scopus subject areas

  • Pharmaceutical Science

Cite this

A systematic review on prevention of Methicillin-Resistant Staphylococcus aureus infection by pre-admission screening : The cost effectiveness and practicality. / Halim, Nurul Izzati Binti Abdul; Rahman, Nor Azlina Binti A.; Mohamad Zin, Noraziah; Baba, Mohd Shukri Bin; Rahman, Nor Iza A.; Haque, Mainul.

In: Systematic Reviews in Pharmacy, Vol. 7, No. 1, 2016, p. 1-19.

Research output: Contribution to journalReview article

Halim, Nurul Izzati Binti Abdul ; Rahman, Nor Azlina Binti A. ; Mohamad Zin, Noraziah ; Baba, Mohd Shukri Bin ; Rahman, Nor Iza A. ; Haque, Mainul. / A systematic review on prevention of Methicillin-Resistant Staphylococcus aureus infection by pre-admission screening : The cost effectiveness and practicality. In: Systematic Reviews in Pharmacy. 2016 ; Vol. 7, No. 1. pp. 1-19.
@article{24a316bc254c483d82bb5a04983c2053,
title = "A systematic review on prevention of Methicillin-Resistant Staphylococcus aureus infection by pre-admission screening: The cost effectiveness and practicality",
abstract = "Background: Methicillin Resistant Staphylococcus aureus (MRSA) is a common source of nosocomial infection, which is spreading through the community and hospitals across the countries. The performance of screening program really needs major effort related to laboratory capacity and ethical consideration, among other costly components. Significant literature research was conducted to review the cost, effectiveness and practicality of different methods of pre-admission MRSA screening in the hospital setting. A systematic literature review was conducted with search strategy using the PubMed Medline, Scopus and the Science Direct databases. The relevant data was abstracted from all studies based on various countries which in line with the finalized eligibility criteria. Results: PCR method was reported to have high sensitivity with low turnaround time as compared to culture method. A review of selected studies found the increasing annual costs of screening from standard culture, chromogenic agar to rapid PCR. In the meantime, other studies reported the total costs for labor and materials was lower for rapid PCR screening compared to culture methods. The culturing method offers a high level of variability due to time consumption and additional costs. Whereas PCR was reported as advantageous in term of saving time to identify MRSA positive patients, which involved isolation, thus increase the effectiveness of screening programs. It can pick up false negative results by conventional methods in the early condition of disease. Conclusion: Most studies verified that PCR is the most accurate method for detection of MRSA with Xpert MRSA having the best performance. Otherwise, oxacillin agar screen was revealed as a good alternative method to PCR. Targeted screening on high risk patients using rapid PCR may be the best choice to be implemented, in order to balance the economic and practicality of screening. We recommend that further clinical studies should be done to provide a sharp evidence of MRSA screening.",
keywords = "Cost-Effectiveness, MRSA, Pre-Admission, Prevention, Screening",
author = "Halim, {Nurul Izzati Binti Abdul} and Rahman, {Nor Azlina Binti A.} and {Mohamad Zin}, Noraziah and Baba, {Mohd Shukri Bin} and Rahman, {Nor Iza A.} and Mainul Haque",
year = "2016",
doi = "10.5530/srp.2016.7.1",
language = "English",
volume = "7",
pages = "1--19",
journal = "Systematic Reviews in Pharmacy",
issn = "0975-8453",
publisher = "Medknow Publications and Media Pvt. Ltd",
number = "1",

}

TY - JOUR

T1 - A systematic review on prevention of Methicillin-Resistant Staphylococcus aureus infection by pre-admission screening

T2 - The cost effectiveness and practicality

AU - Halim, Nurul Izzati Binti Abdul

AU - Rahman, Nor Azlina Binti A.

AU - Mohamad Zin, Noraziah

AU - Baba, Mohd Shukri Bin

AU - Rahman, Nor Iza A.

AU - Haque, Mainul

PY - 2016

Y1 - 2016

N2 - Background: Methicillin Resistant Staphylococcus aureus (MRSA) is a common source of nosocomial infection, which is spreading through the community and hospitals across the countries. The performance of screening program really needs major effort related to laboratory capacity and ethical consideration, among other costly components. Significant literature research was conducted to review the cost, effectiveness and practicality of different methods of pre-admission MRSA screening in the hospital setting. A systematic literature review was conducted with search strategy using the PubMed Medline, Scopus and the Science Direct databases. The relevant data was abstracted from all studies based on various countries which in line with the finalized eligibility criteria. Results: PCR method was reported to have high sensitivity with low turnaround time as compared to culture method. A review of selected studies found the increasing annual costs of screening from standard culture, chromogenic agar to rapid PCR. In the meantime, other studies reported the total costs for labor and materials was lower for rapid PCR screening compared to culture methods. The culturing method offers a high level of variability due to time consumption and additional costs. Whereas PCR was reported as advantageous in term of saving time to identify MRSA positive patients, which involved isolation, thus increase the effectiveness of screening programs. It can pick up false negative results by conventional methods in the early condition of disease. Conclusion: Most studies verified that PCR is the most accurate method for detection of MRSA with Xpert MRSA having the best performance. Otherwise, oxacillin agar screen was revealed as a good alternative method to PCR. Targeted screening on high risk patients using rapid PCR may be the best choice to be implemented, in order to balance the economic and practicality of screening. We recommend that further clinical studies should be done to provide a sharp evidence of MRSA screening.

AB - Background: Methicillin Resistant Staphylococcus aureus (MRSA) is a common source of nosocomial infection, which is spreading through the community and hospitals across the countries. The performance of screening program really needs major effort related to laboratory capacity and ethical consideration, among other costly components. Significant literature research was conducted to review the cost, effectiveness and practicality of different methods of pre-admission MRSA screening in the hospital setting. A systematic literature review was conducted with search strategy using the PubMed Medline, Scopus and the Science Direct databases. The relevant data was abstracted from all studies based on various countries which in line with the finalized eligibility criteria. Results: PCR method was reported to have high sensitivity with low turnaround time as compared to culture method. A review of selected studies found the increasing annual costs of screening from standard culture, chromogenic agar to rapid PCR. In the meantime, other studies reported the total costs for labor and materials was lower for rapid PCR screening compared to culture methods. The culturing method offers a high level of variability due to time consumption and additional costs. Whereas PCR was reported as advantageous in term of saving time to identify MRSA positive patients, which involved isolation, thus increase the effectiveness of screening programs. It can pick up false negative results by conventional methods in the early condition of disease. Conclusion: Most studies verified that PCR is the most accurate method for detection of MRSA with Xpert MRSA having the best performance. Otherwise, oxacillin agar screen was revealed as a good alternative method to PCR. Targeted screening on high risk patients using rapid PCR may be the best choice to be implemented, in order to balance the economic and practicality of screening. We recommend that further clinical studies should be done to provide a sharp evidence of MRSA screening.

KW - Cost-Effectiveness

KW - MRSA

KW - Pre-Admission

KW - Prevention

KW - Screening

UR - http://www.scopus.com/inward/record.url?scp=85008336878&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85008336878&partnerID=8YFLogxK

U2 - 10.5530/srp.2016.7.1

DO - 10.5530/srp.2016.7.1

M3 - Review article

VL - 7

SP - 1

EP - 19

JO - Systematic Reviews in Pharmacy

JF - Systematic Reviews in Pharmacy

SN - 0975-8453

IS - 1

ER -