Better MRSA Strategy: Treat All ICU Patients
The Group 1 strategy, in most hospitals today, in which patients' nasal passages were screened for MRSA on admission to the ICU, and if positive, placed in isolation with glove and gown precautions. This protocol is so common, it is required by law in eight states, which may reconsider their regulations, Huang says.
Michael B. Edmond, MD
In Group 2, all ICU patients were screened and received contact precautions similar to Group 1. But patients known to have MRSA colonization or infection received a five-day regimen of twice-daily mintranasal mupirocin and daily bathing with chlorhexidine cloths
It's unclear whether the cost of administering mupiricin, at about $3 to $4 for the generic version for a course of treatment, and giving a $3 to $5 chlorhexidine daily bath to all ICU patients, will be less expensive compared with screening all ICU patients, which costs $25 to $30 per patient.
Huang and colleagues are working on a cost-effectiveness study, but she pointed out that the cost of treating a patient with a MRSA infection is also high, between $5,000 to $30,000.
In an accompanying editorial, Michael B. Edmond, MD, and Richard P. Wenzel, MD, of the Division of Infectious Diseases at Virginia Commonwealth University School of Medicine in Richmond, noted that the issue has been "one of the most controversial concepts in healthcare epidemiology during the past decade."
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