MRSA screening ‘cost-effective’

This is provided patients found to be MRSA positive can be treated promptly with antiseptic washes or nasal antimicrobials that can suppress or clear the MRSA, and resistance to these treatments does not become a major issue. Study author Dr Julie Robotham, a HPA health economist, said: “Our research shows that new rapid MRSA screening technologies can represent good value for money in ICUs, but it also highlights the need for further research into the best methods to minimise the risk of MRSA infection and onward spread in these settings. “Our analysis is aimed at people who have to make difficult spending decisions within the NHS and who seek to provide the best patient care with the budget available to them.” There are currently a number of options available to screen for MRSA, ranging from expensive molecular tests which can give a result in a few hours to conventional laboratory tests which are cheaper but take three days or more to give a result. In England, all relevant patients should be screened and NHS organisations have been encouraged to develop local screening protocols based on their experience of screening. However, questions remain over which screening and control methods are most effective and best value for money. The HPA model-based study addressed both the effectiveness and cost-effectiveness (value for money) of the various combinations of screening, decolonisation and isolation control practices available for ICUs, where MRSA infections are most life-threatening and costly. The study found that universal decolonisation using chlorhexidine had a far higher probability of being cost-effective than any other strategy. At a willingness to pay threshold of £30,000 per QALY, universal decolonisation using chlorhexidine had about a 70% chance of being cost-effective.