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Journal of Clinical Microbiology, July 2008, p. 2151-2154, Vol. 46, No. 7
0095-1137/08/$08.00+0     doi:10.1128/JCM.01957-07
Copyright © 2008, American Society for Microbiology. All Rights Reserved.

Rapid Screening for Carriage of Methicillin-Resistant Staphylococcus aureus by PCR and Associated Costs{triangledown}

Manuela Bühlmann,1 Katja Bögli-Stuber,2 Sara Droz,2 and Kathrin Mühlemann1,2*

Department of Infectious Diseases, University Hospital Bern, Bern, Switzerland,1 Institute for Infectious Diseases, University of Bern, Bern, Switzerland2

Received 4 October 2007/ Returned for modification 24 December 2007/ Accepted 15 April 2008

PCR tests for the rapid and valid detection of methicillin-resistant Staphylococcus aureus (MRSA) are now available. We evaluated the costs associated with contact screening for MRSA carriage in a tertiary-care hospital with low MRSA endemicity. Between 1 October 2005 and 28 February 2006, 232 patients were screened during 258 screening episodes (644 samples) for MRSA carriage by GenoType MRSA Direct (Hain Lifescience GmbH, Nehren, Germany). Conventional culture confirmed all PCR results. According to in-house algorithms, 34 of 258 screening episodes (14.7%) would have qualified for preemptive contact isolation, but such isolation was not done upon negative PCR results. MRSA carriage was detected in 4 (1.5%) of 258 screening episodes (i.e., in four patients), of which none qualified for preemptive contact isolation. The use of PCR for all 258 screening episodes added costs (in Swiss francs [CHF]) of CHF 104,328.00 and saved CHF 38,528.00 (for preemptive isolation). The restriction of PCR screening to the 34 episodes that qualified for preemptive contact isolation and screening all others by culture would have lowered costs for PCR to only CHF 11,988.00, a savings of CHF 38,528.00. Therefore, PCR tests are valuable for the rapid detection of MRSA carriers, but high costs require the careful evaluation of their use. In patient populations with low MRSA endemicity, the broad use of PCR probably is not cost-effective.

* Corresponding author. Mailing address: Institute for Infectious Diseases, University of Bern, Friedbühlstrasse 51, 3010 Bern, Switzerland. Phone: 41 31 632 32 59. Fax: 41 31 632 87 66. E-mail: kathrin.muehlemann{at}ifik.unibe.ch

{triangledown} Published ahead of print on 30 April 2008.

Journal of Clinical Microbiology, July 2008, p. 2151-2154, Vol. 46, No. 7
0095-1137/08/$08.00+0     doi:10.1128/JCM.01957-07
Copyright © 2008, American Society for Microbiology. All Rights Reserved.





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