Cost analysis of outbreaks with Methicillin-resistant Staphylococcus aureus (MRSA) in Dutch long-term care facilities (LTCF)

Rijt, Antonius Mattheus van; Dik, Jan-Willem H.; Lokate, Mariëtte; Postma, Maarten J.; Friedrich, Alex

doi:10.1371/journal.pone.0208092

Cited by 5 publications

(3 citation statements)

References 18 publications

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“…Using 2021 as a base year for comparing our cost estimates with other studies, we found our estimated extra patient cost of AMR was less compared with another study conducted in a hospital in Connecticut, USA, which shows that the excess expense per patient due to AMR was equivalent to US$1871 [ 23 ]. Furthermore, an increasing number of studies, mainly conducted in Europe and the US, report a higher patient cost of AMR with variation in excess cost depending on the bacteraemia type, sample size, study perspective, and location [ 21 , 46 , 51 – 53 ]. Nonetheless, we are cautious in comparing our estimated costs with available studies conducted in Europe and the US due to complete differences in socioeconomic circumstances.…”

Section: Discussionmentioning

confidence: 99%

Attributable Patient Cost of Antimicrobial Resistance: A Prospective Parallel Cohort Study in Two Public Teaching Hospitals in Ghana

Otieku

Fenny

Ofori

et al. 2023

PharmacoEconomics Open

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Objective The aim of this study was to evaluate the attributable patient cost of antimicrobial resistance (AMR) in Ghana to provide empirical evidence to make a case for improved AMR preventive strategies in hospitals and the general population. Methods A prospective parallel cohort design in which participants were enrolled at the time of hospital admission and remained until 30 days after the diagnosis of bacteraemia or discharge from the hospital/death. Patients were matched on age group (± 5 years the age of AMR patients), treatment ward, sex, and bacteraemia type. The AMR cohort included all inpatients with a positive blood culture of Escherichia coli or Klebsiella spp., resistant to third-generation cephalosporins (3GC), or methicillin-resistant Staphylococcus aureus (MRSA). We matched the AMR cohort (n = 404) with two control arms, i.e., patients with the same bacterial infections susceptible to 3GC or S. aureus that was methicillin-susceptible (susceptible cohort; n = 152), and uninfected patients (uninfected cohort; n = 404). Settings were Korle-Bu and Komfo Anokye Teaching Hospitals, Ghana. The outcome measures were the length of hospital stay (LOS) and the associated patient costs. Outcomes were evaluated from the patient perspective. Results From a total of 5752 blood cultures screened, 1836 participants had growth in blood culture, of which, based on our inclusion criteria, 426 were enrolled into the AMR cohort; however, only 404 completed the follow-up and were matched with participants in the two control cohorts. Patients in the AMR cohort stayed approximately 5 more days (95% confidence interval [CI] 4.0-6.0) and 8 more days (95% CI 7.2-8.6) compared with the susceptible and uninfected cohorts, respectively. The mean extra patient cost due to AMR relative to the susceptible cohort was US$1300 (95% CI 1018-1370), of which about 30% resulted from productivity loss due to presenteeism and absenteeism from work. Overall, the estimated annual patient cost due to AMR translates to about US$1 million and US$1.4 million when compared with the susceptible and uninfected cohorts, respectively. Conclusion We have shown that AMR is associated with a significant excess LOS and patient costs in Ghana using prospective data from two public tertiary hospitals. This calls for infection prevention and control strategies aimed at mitigating the prevalence of AMR.

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Section: Discussionmentioning

confidence: 99%

Attributable Patient Cost of Antimicrobial Resistance: A Prospective Parallel Cohort Study in Two Public Teaching Hospitals in Ghana

Otieku

Fenny

Ofori

et al. 2023

PharmacoEconomics Open

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“…Probability of chronic COVID taken from the fatigue estimate given in [ 33 ] QALY loss, death Net present value of total QALYs lost from [ 32 ], modified with Canadian population norms and SDs Incremental cost, hospitalisation and ICU admission Per diem median $1391.80, 90th percentile $1852.52 Gamma distribution: α = 18.5, β = 0.01 Alberta Health Interactive Health Data Application, CMG+ 2018 Grouper 133, Infectious/Parasitic Disease of Respiratory System [ 34 ]. Inflation adjusted from 2018 to 2020 using Canada All-Item inflation [ 35 ] Incremental cost, LTC case Per diem mean $337.65, SD $548.14 Gamma distribution: α = 0.8547, β = 0.0025 Cost from [ 36 ] converted to CAD using average 2015 exchange rate, inflation adjusted from 2015 to 2020 using Canada All-Item inflation [ 35 ] Incremental cost, chronic COVID Annual cost of $10,020, with probability 34.8% Beta distribution for probability: α = 2.410903, β = 4.516979 Weighted expected annual cost for common chronic conditions associated with chronic COVID. See the ESM for details.…”

Section: Methodsmentioning

confidence: 99%

A Net Benefit Approach for the Optimal Allocation of a COVID-19 Vaccine

et al. 2021

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Objective The objective of this study was to implement a model-based approach to identify the optimal allocation of a coronavirus disease 2019 (COVID-19) vaccine in the province of Alberta, Canada. Methods We developed an epidemiologic model to evaluate allocation strategies defined by age and risk target groups, coverage, effectiveness and cost of vaccine. The model simulated hypothetical immunisation scenarios within a dynamic context, capturing concurrent public health strategies and population behavioural changes. Results In a scenario with 80% vaccine effectiveness, 40% population coverage and prioritisation of those over the age of 60 years at high risk of poor outcomes, active cases are reduced by 17% and net monetary benefit increased by $263 million dollars, relative to no vaccine. Concurrent implementation of policies such as school closure and senior contact reductions have similar impacts on incremental net monetary benefit ($352 vs $292 million, respectively) when there is no prioritisation given to any age or risk group. When older age groups are given priority, the relative benefit of school closures is much larger ($214 vs $118 million). Results demonstrate that the rank ordering of different prioritisation options varies by prioritisation criteria, vaccine effectiveness and coverage, and concurrently implemented policies. Conclusions Our results have three implications: (i) optimal vaccine allocation will depend on the public health policies in place at the time of allocation and the impact of those policies on population behaviour; (ii) outcomes of vaccine allocation policies can be greatly supported with interventions targeting contact reduction in critical sub-populations; and (iii) identification of the optimal strategy depends on which outcomes are prioritised. Supplementary Information The online version contains supplementary material available at 10.1007/s40273-021-01037-2.

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“…It is found colonizing the nostrils of approximately 20%-30% of the adult population (Mulcahy and McLoughlin 2016;Krismer et al 2017), and current studies have also shown the occurrence of S. aureus and methicillin-resistant S. aureus (MRSA) in healthy children and youth (Hussein et al 2015;Kateete et al 2019). MRSA is associated with a variety of infections that cause high morbidity, mortality, and healthcare costs, such as hospitalization in the intensive care unit (ICU), generating considerable socioeconomic impacts (Chatterjee et al 2018;van Rijt et al 2018) Fouda et al (2016) corroborate this finding, in which 70% of healthcare professionals were stable MRSA carriers. To address this issue, systematic surveillance and research efforts are required (Rasigade et al 2014).…”

Section: Introductionmentioning

confidence: 99%

Effects of ketamine in methicillin-resistant Staphylococcus aureus and in silico interaction with sortase A

et al. 2021

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Methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) is one of the main human pathogens and is responsible for many diseases ranging from skin infections to more invasive infections. These infections are dangerous and expensive to treat because these strains are resistant to a large number of conventional antibiotics. Having said that, Antibacterial effect of ketamine against MRSA strains, its mechanism of action and in silico interaction with sortase A was evaluated. The antibacterial effect of ketamine was assessed by the broth microdilution method. Subsequently, the mechanism of action was assessed using flow cytometry and molecular docking assays with sortase A. Our results showed that Ketamine has a significant antibacterial activity against MRSA strains in the range of 2.49 to 3.73 mM. Their mechanism of action involves alterations in the membrane integrity and DNA damage, reducing cell viability that provoke death by apoptosis. In addition, Ketamine compound had affinity for S. aureus sortase A. These results indicate that this compound can be an alternative to develop new strategies to combat of infections caused by MRSA.

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Cost analysis of outbreaks with Methicillin-resistant Staphylococcus aureus (MRSA) in Dutch long-term care facilities (LTCF)

Cited by 5 publications

References 18 publications

Attributable Patient Cost of Antimicrobial Resistance: A Prospective Parallel Cohort Study in Two Public Teaching Hospitals in Ghana

Attributable Patient Cost of Antimicrobial Resistance: A Prospective Parallel Cohort Study in Two Public Teaching Hospitals in Ghana

A Net Benefit Approach for the Optimal Allocation of a COVID-19 Vaccine

Effects of ketamine in methicillin-resistant Staphylococcus aureus and in silico interaction with sortase A

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