Skip to main content Accessibility help
×
Home

Costs and Savings Associated With Infection Control Measures That Reduced Transmission of Vancomycin-Resistant Enterococci in an Endemic Setting

  • Marisa A. Montecalvo (a1), William R. Jarvis (a2), Jane Uman (a3), David K. Shay (a2), Coleen Petrullo (a1), Harold W. Horowitz (a1) and Gary P. Wormser (a1)...

Abstract

Objective:

To determine the costs and savings of a 15-component infection control program that reduced transmission of vancomycin-resistant enterococci (VRE) in an endemic setting.

Design:

Evaluation of costs and savings, using historical control data.

Setting:

Adult oncology unit of a 650-bed hospital.

Participants:

Patients with leukemia, lymphoma, and solid tumors, excluding bone marrow transplant recipients.

Methods:

Costs and savings with estimated ranges were calculated. Excess length of stay (LOS) associated with VRE bloodstream infection (BSI) was determined by matching VRE BSI patients with VRE-negative patients by oncology diagnosis. Differences in LOS between the matched groups were evaluated using a mixed-effect analysis of variance linear-regression model.

Results:

The cost of enhanced infection control strategies for 1 year was $116,515. VRE BSI was associated with an increased LOS of 13.7 days. The savings associated with fewer VRE BSI ($123,081), fewer patients with VRE colonization ($2,755), and reductions in antimicrobial use ($179,997) totaled $305,833. Estimated ranges of costs and savings for enhanced infection control strategies were $97,939 to $148,883 for costs and $271,531 to $421,461 for savings.

Conclusion:

The net savings due to enhanced infection control strategies for 1 year was $189,318. Estimates suggest that these strategies would be cost-beneficial for hospital units where the number of patients with VRE BSI is at least see to nine patients per year or if the savings from fewer VRE BSI patients in combination with decreased antimicrobial use equalled $100,000 to $150,000 per year.

Copyright

Corresponding author

Division of Infectious Diseases, New York Medical College, Macy Pavilion 209SE, Valhalla, NY 10595

References

Hide All
1.Centers for Disease Control and Prevention. Nosocomial enterococci resistant to vancomycin—United States, 1989-1993. MMWR 1993;42:597599.
2.Hospital Infection Control Practices Advisory Committee, Centers for Disease Control and Prevention. Recommendations for preventing the spread of vancomycin resistance. MMWR 1995;44(RR-12):13.
3.Moellering, R, Linden, P, Reinhardt, J, Blumberg, E, Bopart, F, Talbot, G. The efficacy and safety of quinupristin/dalfopristin for the treatment of infections caused by vancomycin-resistant Enterococcus faecium. Synercid Emergency-Use Study Group. J Antimicrob Chemother 1999;44:251261.
4.Gonzales, RD, Schreckenberger, PC, Graham, MB, Kelkar, S, DenBesten, K, Quinn, JP. Infections due to vancomycin-resistant Enterococcus faecium resistant to linezolid. Lancet 2001;357:1179.
5.Montecalvo, MA, Jarvis, WR, Uman, J, Shay, DK, Petrullo, C, Rodney, K, et al.Infection control measures reduce transmission of vancomycin-resistant enterococci in an endemic setting. Ann Intern Med 1999;131:269272.
6.Garner, JS, Jarvis, WR, Emori, TG, Horan, TC, Hughes, JM. CDC definitions for nosocomial infections, 1988. Am J Infect Control 1988;16:128140.
7.Knaus, WA, Draper, EA, Wagner, DP, Zimmerman, JE. APACHE II: a severity of disease classification system. Crit Care Med 1985;13:818828.
8.Haley, RW. Measuring the costs of nosocomial infections: methods for estimating economic burden on the hospital. Am J Med 1991;91(3B):3238.
9.1995 Drug Topics Redbook. Montvale, NJ: Medical Economics Co, Inc; 1995.
10.Edmond, MB, Ober, JF, Dawson, JD, Weinbaum, DL, Wenzel, RP. Vancomycin-resistant enterococcal bacteremia: natural history and attributable mortality. Clin Infect Dis 1996;23:12341239.
11.Montecalvo, MA, de Lencastre, H, Carraher, M, Gedris, C, Chung, M, Van Horn, K, et al.Natural history of colonization with vancomycin-resistant Enterococcus faecium. Infect Control Hosp Epidemiol 1995;16:680685.

Related content

Powered by UNSILO

Costs and Savings Associated With Infection Control Measures That Reduced Transmission of Vancomycin-Resistant Enterococci in an Endemic Setting

  • Marisa A. Montecalvo (a1), William R. Jarvis (a2), Jane Uman (a3), David K. Shay (a2), Coleen Petrullo (a1), Harold W. Horowitz (a1) and Gary P. Wormser (a1)...

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.