Budget Impact Analysis of Rapid Screening for Staphylococcus aureus Colonization Among Patients Undergoing Elective Surgery in US Hospitals

2008 ◽  
Vol 29 (1) ◽  
pp. 16-24 ◽  
Author(s):  
Gary A. Noskin ◽  
Robert J. Rubin ◽  
Jerome J. Schentag ◽  
Jan Kluytmans ◽  
Edwin C. Hedblom ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Sensitivity Analysis ◽  
Budget Impact ◽  
Elective Surgery ◽  
Cost Savings ◽  
Nasal Carriage ◽  
Rapid Screening ◽  
Marginal Effect ◽  
Primary Input ◽  
Input Variables

Objective.To evaluate the economic impact of performing rapid testing for Staphylococcus aureus colonization before admission for all inpatients who are scheduled to undergo elective surgery and providing subsequent decolonization therapy for those patients found to be colonized with S. aureus.Methods.A budget impact model that used probabilistic sensitivity analysis to account for the uncertainties in the input variables was developed. Primary input variables included the marginal effect of S. aureus infection on patient outcomes among patients who underwent elective surgery, patient demographic characteristics, the prevalence of nasal carriage of S. aureus, the sensitivity and specificity of the rapid diagnostic test for S. aureus colonization, the efficacy of decolonization therapy for nasal carriage of S. aureus, and cost data. Data sources for the input variables included the 2003 Nationwide Inpatient Sample data and the published literature.Results.In 2003, there were an estimated 7,181,484 patients admitted to US hospitals for elective surgery. Our analysis indicated preadmission testing and subsequent decolonization therapy for patients colonized with S. aureus would have produced a mean annual cost savings to US hospitals of $231,538,400 (95% confidence interval [CI], -$300 million to $1.3 billion). The mean annual number of hospital-days that could have been eliminated was estimated at 364,919 days (95% CI, 67,893-926,983 days), and a mean of 935 in-hospital deaths (95% CI, 88-3,691) could have been avoided per year. Sensitivity analysis indicated a 64.5% probability that there would be cost savings to US hospitals as a result of preadmission testing and subsequent decolonization therapy.Conclusion.The addition of preadmission testing and decolonization therapy to standard care would result in significant cost savings, even after accounting for variations in the model input values.

Staphylococcus aureus nasal colonization among Vietnamese adults: prevalence, risk factors and antibiotic susceptibility profile

MedPharmRes ◽  
2018 ◽  
Vol 2 (2) ◽  
pp. 21-31
Author(s):  
Nguyen Phan ◽  
Hien Pham ◽  
Thuc Nguyen ◽  
Hoai Nguyen
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Antibiotic Susceptibility ◽  
Nasal Carriage ◽  
Resistance Rate ◽  
High Rate ◽  
Weight History ◽  
Potential Risk Factors ◽  
History Of ◽  
Vietnamese Community

Staphylococcus aureus (S. aureus) has long been recognized as an important human pathogen causing many severe diseases. It is also a part of human normal flora with its ecological niche in the human anterior nares. This study focused on screening S. aureus nasal carriage in community and its relationship to human physiological and pathological factors which have not been studied in Vietnam previously. Two hundred and five volunteers in Ho Chi Minh City from 18 to 35 and over 59 years old both male and female participated in the study. Result showed that the prevalence of S. aureus nasal carriage in southern Vietnamese community was relatively low, only 11.2% (23/205), much lower than that in other international reports on human S. aureus. In addition, nasal carriage of the older age group (> 59 years old, 13.7%) was higher than that of younger age (18-35 years old, 10.4%). Other potential risk factors such as gender, career, height, weight, history of antibiotic usage, daily nasal wash, use of nasal medication sprays, acne problems, smoking and nasal problems showed no significant impact on S. aureus carriage. The obtained S. aureus nasal isolates were all sensitive to vancomycin. Lincomycin and tetracycline had low resistance rate with 4.3 % and 17.4 %, respectively. However, the isolates showed particularly high rate of multidrug resistance (54.2%) In summary, our data provided researchers an overview on S. aureus nasal carriage and antibiotic susceptibility profile of the community- isolated S. aureus in Vietnam. This would serve as valuable information on assessing risk of community-acquired S. aureus infections.

NASAL CARRIAGE OF STAPHYLOCOCCUS AUREUS AS A RISK OF NOSOCOMIAL INFECTIONS

2014 ◽  
Vol 5 (4) ◽  
pp. 205-209
Author(s):  
MAŁGORZATA M. KOZIOŁ ◽  
AGNIESZKA SIKORA ◽  
SYLWIA TARGOŃSKA ◽  
ANNA SIKORA
Keyword(s):  
Staphylococcus Aureus ◽  
Nosocomial Infections ◽  
Nasal Carriage

Staphylococcus aureus Nasal Carriage in Medical Students of Universiti Teknologi MARA

2017 ◽  
Vol 2 (1) ◽  
pp. 29 ◽  
Author(s):  
Zaini Mohd Zain ◽  
Muhammad Fikri Johari ◽  
Nurul Shahirah Mohd Husin ◽  
Nurul Syamimi Rozman ◽  
Athirah Ab Rashid ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Medical Students ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Nasal Carriage ◽  
Tissue Necrosis ◽  
Mannitol Salt Agar ◽  
Microbiological Techniques ◽  
Polymerase Chain ◽  
Low Prevalence ◽  
Panton Valentine Leukocidin

Introduction: To determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) nasal carriage and detection of S. aureus leukotoxins among medical students of Universiti Teknologi MARA. Methods: Both sides of the anterior nares of 136 volunteers, comprising 68 preclinical and 68 clinical medical students, were swabbed and immediately cultured onto mannitol salt agar for growth of S. aureus. Standard microbiological techniques were conducted to identify and confirm the S. aureus colonies and susceptibility test against oxacillin were conducted by using Kirby-Bauer method to determine their resistance to methicillin. Polymerase chain reaction was performed for detection of leukotoxins, i.e., Panton-Valentine Leukocidin (PVL) and -haemolysin genes. Results: Nineteen students (14%) consisting of 10 preclinical (14.7%) and 9 clinical (13.2%) were nasal carriers of S. aureus. However, none of the S. aureus isolates were MRSA. No PVL gene was detected but eight of them were positive for -haemolysin gene. Conclusion: There were no MRSA nasal carriers among the medical students, but a low prevalence of S. aureus nasal carriers was detected. These carriers do not pose as high risk because none of the strains of S. aureus possess both the -haemolysin toxin and the PVL toxin that are associated with tissue necrosis.

scholarly journals A Novel Global Sensitivity Measure Based on Probability Weighted Moments

Symmetry ◽  
2021 ◽  
Vol 13 (1) ◽  
pp. 90
Author(s):  
Shufang Song ◽  
Lu Wang
Keyword(s):  
Sensitivity Analysis ◽  
Global Sensitivity Analysis ◽  
Small Samples ◽  
Double Loop ◽  
Numerical Estimation ◽  
Global Sensitivity ◽  
Sensitivity Measure ◽  
Probability Weighted Moments ◽  
Input Variables ◽  
Single Set

Global sensitivity analysis (GSA) is a useful tool to evaluate the influence of input variables in the whole distribution range. Variance-based methods and moment-independent methods are widely studied and popular GSA techniques despite their several shortcomings. Since probability weighted moments (PWMs) include more information than classical moments and can be accurately estimated from small samples, a novel global sensitivity measure based on PWMs is proposed. Then, two methods are introduced to estimate the proposed measure, i.e., double-loop-repeated-set numerical estimation and double-loop-single-set numerical estimation. Several numerical and engineering examples are used to show its advantages.

Staphylococcus aureus Carriage in Hidradenitis Suppurativa: Impact on Response to Adalimumab

Dermatology ◽  
2021 ◽  
pp. 1-6
Author(s):  
Dimitra Stergianou ◽  
Vassiliki Tzanetakou ◽  
Maria Argyropoulou ◽  
Theodora Kanni ◽  
Pantelis G. Bagos ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Clinical Response ◽  
Odds Ratio ◽  
Hidradenitis Suppurativa ◽  
Positive Culture ◽  
Nasal Carriage ◽  
Loss Of Response ◽  
Response Score ◽  
Stimulation Of

<b><i>Background:</i></b> Several patients with hidradenitis suppurativa (HS) present flare-ups during treatment with adalimumab (ADA), the cause of which is not clear. ADA is the only FDA-approved biologic for the therapy of moderate-to-severe HS. A previous study of our group has shown that <i>Staphylococcus aureus</i> stimulation of whole blood affects the production of human β-defensin 2 and modulates HS severity. It is, therefore, hypothesized, that carriage of <i>S. aureus</i> may drive HS flare-ups. <b><i>Objective:</i></b> To explore the association between carriage of <i>S. aureus</i> and loss of response to ADA. <b><i>Patients and Methods:</i></b> Among patients with moderate-to-severe HS without carriage of <i>S. aureus</i> at start of treatment with ADA, we investigated for carriage of <i>S. aureus</i> from the nares when flare-ups occurred. Flare-ups were pre-defined as at least 25% increase of inflammatory lesions (sum of inflammatory nodules and abscesses) from baseline. Samplings were also done after completion of 12 weeks of ADA treatment from all patients who did not present flare-ups. Clinical response to ADA was assessed by the HS Clinical Response score (HiSCR). <b><i>Results:</i></b> Thirty-nine patients were studied; 24 with Hurley II stage HS and 15 with Hurley III stage HS. Twenty-nine patients achieved HiSCR after 12 weeks of treatment without any flare-ups; 10 patients had flare-ups and failed HiSCR. Three (10.3%) and 5 (50%) patients, respectively, had nasal carriage of <i>S. aureus</i> (odds ratio 8.67; 95% CI 1.54–48.49; <i>p</i> = 0.014). Among 32 patients reaching follow-up week 48, 20 patients achieved HiSCR and 12 had flare-ups leading to ADA failure; 2 (10%) and 5 (41.7%) patients, respectively, had positive culture for <i>S. aureus</i> (odds ratio 6.42; 95% CI 1.00–41.20; <i>p</i> = 0.05). <b><i>Conclusion:</i></b> Nasal carriage of <i>S. aureus</i> may be associated with loss of response to ADA. Findings need confirmation in larger series of patients.

Sign in / Sign up

Export Citation Format

Share Document