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A systematic review on prevention of methicillin-resistant Staphylococcus aureus infection by pre-admission screening: the cost effectiveness and practicality

Background: Methicillin Resistant Staphylococcus aureus (MRSA) is a common source of nosocomial infection, which is spreading through the community and hospitals across the countries. The performance of screening program really needs major effort related to laboratory capacity and ethical considerat...

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Main Authors: Abdul Halim, Nurul Izzati, A. Rahman, Nor Azlina, Mohamad Zin, Noraziah, Baba, Mohd Shukri, A.Rahman, Nor Iza, Haque, Mainul
Format: Article
Language:English
English
Published: Phcog.Net 2016
Subjects:
R Medicine (General)
Online Access:http://irep.iium.edu.my/52778/1/2016%20%275%20SR%20MRSA.pdf
http://irep.iium.edu.my/52778/7/52778_A%20systematic%20review%20on%20prevention_Scopus.pdf
http://irep.iium.edu.my/52778/
http://www.sysrevpharm.org/article/83
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spelling my.iium.irep.527782022-06-30T03:47:36Z http://irep.iium.edu.my/52778/ A systematic review on prevention of methicillin-resistant Staphylococcus aureus infection by pre-admission screening: the cost effectiveness and practicality Abdul Halim, Nurul Izzati A. Rahman, Nor Azlina Mohamad Zin, Noraziah Baba, Mohd Shukri A.Rahman, Nor Iza Haque, Mainul R Medicine (General) Background: Methicillin Resistant Staphylococcus aureus (MRSA) is a common source of nosocomial infection, which is spreading through the community and hospitals across the countries. The performance of screening program really needs major effort related to laboratory capacity and ethical consideration, among other costly components. Significant literature research was conducted to review the cost, effectiveness and practicality of different methods of pre-admission MRSA screening in the hospital setting. A systematic literature review was conducted with search strategy using the PubMed Medline, Scopus and the Science Direct databases. The relevant data was abstracted from all studies based on various countries which in line with the finalized eligibility criteria. Results: PCR method was reported to have high sensitivity with low turnaround time as compared to culture method. A review of selected studies found the increasing annual costs of screening from standard culture, chromogenic agar to rapid PCR. In the meantime, other studies reported the total costs for labor and materials was lower for rapid PCR screening compared to culture methods. The culturing method offers a high level of variability due to time consumption and additional costs. Whereas PCR was reported as advantageous in term of saving time to identify MRSA positive patients, which involved isolation, thus increase the effectiveness of screening programs. It can pick up false negative results by conventional methods in the early condition of disease. Conclusion: Most studies verified that PCR is the most accurate method for detection of MRSA with Xpert MRSA having the best performance. Otherwise, oxacillin agar screen was revealed as a good alternative method to PCR. Targeted screening on high risk patients using rapid PCR may be the best choice to be implemented, in order to balance the economic and practicality of screening. We recommend that further clinical studies should be done to provide a sharp evidence of MRSA screening. Phcog.Net 2016 Article PeerReviewed application/pdf en http://irep.iium.edu.my/52778/1/2016%20%275%20SR%20MRSA.pdf application/pdf en http://irep.iium.edu.my/52778/7/52778_A%20systematic%20review%20on%20prevention_Scopus.pdf Abdul Halim, Nurul Izzati and A. Rahman, Nor Azlina and Mohamad Zin, Noraziah and Baba, Mohd Shukri and A.Rahman, Nor Iza and Haque, Mainul (2016) A systematic review on prevention of methicillin-resistant Staphylococcus aureus infection by pre-admission screening: the cost effectiveness and practicality. Systematic Reviews in Pharmacy, 7 (1). pp. 1-19. ISSN 0975-8453 E-ISSN 0976-2779 http://www.sysrevpharm.org/article/83 10.5530/srp.2016.7.1
institution Universiti Islam Antarabangsa Malaysia
building IIUM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider International Islamic University Malaysia
content_source IIUM Repository (IREP)
url_provider http://irep.iium.edu.my/
language English
English
topic R Medicine (General)
spellingShingle R Medicine (General)
Abdul Halim, Nurul Izzati
A. Rahman, Nor Azlina
Mohamad Zin, Noraziah
Baba, Mohd Shukri
A.Rahman, Nor Iza
Haque, Mainul
A systematic review on prevention of methicillin-resistant Staphylococcus aureus infection by pre-admission screening: the cost effectiveness and practicality
description Background: Methicillin Resistant Staphylococcus aureus (MRSA) is a common source of nosocomial infection, which is spreading through the community and hospitals across the countries. The performance of screening program really needs major effort related to laboratory capacity and ethical consideration, among other costly components. Significant literature research was conducted to review the cost, effectiveness and practicality of different methods of pre-admission MRSA screening in the hospital setting. A systematic literature review was conducted with search strategy using the PubMed Medline, Scopus and the Science Direct databases. The relevant data was abstracted from all studies based on various countries which in line with the finalized eligibility criteria. Results: PCR method was reported to have high sensitivity with low turnaround time as compared to culture method. A review of selected studies found the increasing annual costs of screening from standard culture, chromogenic agar to rapid PCR. In the meantime, other studies reported the total costs for labor and materials was lower for rapid PCR screening compared to culture methods. The culturing method offers a high level of variability due to time consumption and additional costs. Whereas PCR was reported as advantageous in term of saving time to identify MRSA positive patients, which involved isolation, thus increase the effectiveness of screening programs. It can pick up false negative results by conventional methods in the early condition of disease. Conclusion: Most studies verified that PCR is the most accurate method for detection of MRSA with Xpert MRSA having the best performance. Otherwise, oxacillin agar screen was revealed as a good alternative method to PCR. Targeted screening on high risk patients using rapid PCR may be the best choice to be implemented, in order to balance the economic and practicality of screening. We recommend that further clinical studies should be done to provide a sharp evidence of MRSA screening.
format Article
author Abdul Halim, Nurul Izzati
A. Rahman, Nor Azlina
Mohamad Zin, Noraziah
Baba, Mohd Shukri
A.Rahman, Nor Iza
Haque, Mainul
author_facet Abdul Halim, Nurul Izzati
A. Rahman, Nor Azlina
Mohamad Zin, Noraziah
Baba, Mohd Shukri
A.Rahman, Nor Iza
Haque, Mainul
author_sort Abdul Halim, Nurul Izzati
title A systematic review on prevention of methicillin-resistant Staphylococcus aureus infection by pre-admission screening: the cost effectiveness and practicality
title_short A systematic review on prevention of methicillin-resistant Staphylococcus aureus infection by pre-admission screening: the cost effectiveness and practicality
title_full A systematic review on prevention of methicillin-resistant Staphylococcus aureus infection by pre-admission screening: the cost effectiveness and practicality
title_fullStr A systematic review on prevention of methicillin-resistant Staphylococcus aureus infection by pre-admission screening: the cost effectiveness and practicality
title_full_unstemmed A systematic review on prevention of methicillin-resistant Staphylococcus aureus infection by pre-admission screening: the cost effectiveness and practicality
title_sort systematic review on prevention of methicillin-resistant staphylococcus aureus infection by pre-admission screening: the cost effectiveness and practicality
publisher Phcog.Net
publishDate 2016
url http://irep.iium.edu.my/52778/1/2016%20%275%20SR%20MRSA.pdf
http://irep.iium.edu.my/52778/7/52778_A%20systematic%20review%20on%20prevention_Scopus.pdf
http://irep.iium.edu.my/52778/
http://www.sysrevpharm.org/article/83
_version_ 1738510092550012928
score 13.211869

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