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

Published online by Cambridge University Press:  02 January 2015

Marisa A. Montecalvo*
Affiliation:
Division of Infectious Diseases, New York Medical College, Valhalla, New York
William R. Jarvis
Affiliation:
Hospital Infections Program, Centers for Disease Control and Prevention, Atlanta, Georgia
Jane Uman
Affiliation:
Graduate School of Health Sciences, New York Medical College, Valhalla, New York
David K. Shay
Affiliation:
Hospital Infections Program, Centers for Disease Control and Prevention, Atlanta, Georgia
Coleen Petrullo
Affiliation:
Division of Infectious Diseases, New York Medical College, Valhalla, New York
Harold W. Horowitz
Affiliation:
Division of Infectious Diseases, New York Medical College, Valhalla, New York
Gary P. Wormser
Affiliation:
Division of Infectious Diseases, New York Medical College, Valhalla, New York
*Corresponding
Division of Infectious Diseases, New York Medical College, Macy Pavilion 209SE, Valhalla, NY 10595

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.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2001

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References

1.Centers for Disease Control and Prevention. Nosocomial enterococci resistant to vancomycin—United States, 1989-1993. MMWR 1993;42:597599.Google ScholarPubMed
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.Google ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle Scholar
6.Garner, JS, Jarvis, WR, Emori, TG, Horan, TC, Hughes, JM. CDC definitions for nosocomial infections, 1988. Am J Infect Control 1988;16:128140.CrossRefGoogle ScholarPubMed
7.Knaus, WA, Draper, EA, Wagner, DP, Zimmerman, JE. APACHE II: a severity of disease classification system. Crit Care Med 1985;13:818828.CrossRefGoogle ScholarPubMed
8.Haley, RW. Measuring the costs of nosocomial infections: methods for estimating economic burden on the hospital. Am J Med 1991;91(3B):3238.CrossRefGoogle ScholarPubMed
9.1995 Drug Topics Redbook. Montvale, NJ: Medical Economics Co, Inc; 1995.Google Scholar
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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Costs and Savings Associated With Infection Control Measures That Reduced Transmission of Vancomycin-Resistant Enterococci in an Endemic Setting
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