Methicillin-resistant Staphylococcus aureus:: A public health issue with economic consequences
Methicillin-resistant Staphylococcus aureus:: A public health issue with economic consequences
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DOI：
10.1155/2007/253947
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发表时间：
2007-01-01
影响因子：
2.8
通讯作者：
Vicente, Colin
中科院分区：
文献类型：
--
作者：
Goetghebeur, Mireille;Landry, Pierre-Alexandre;Vicente, Colin
背景：耐甲氧西林金黄色葡萄球菌(MRSA)已成为全球医院的地方病，社区相关的MRSA正在向社区蔓延。目的：估计目前在加拿大的MRSA的成本，并评估这一公共卫生问题的严重性。方法：通过广泛的文献综述，收集在加拿大环境下MRSA的流行病学、医疗资源利用和成本数据。目前的MRSA负担是使用现有的成本数据和最新的流行病学数据来估计的。结果：1995-2004年间，加拿大医院的MRSA感染率从每1000名住院患者中的0.46上升到5.90，而社区相关的MRSA继续蔓延到社区。携带MRSA的患者需要长期住院(每名患者平均隔离26天)、特殊控制措施、昂贵的治疗和广泛的监测。每个感染的MRSA患者的总成本平均为12,216美元，其中住院是主要的成本驱动因素(81%)，其次是屏障预防措施(13%)、抗菌治疗(4%)和实验室检查(2%)。最新的流行病学数据，结合现有的成本数据表明，在加拿大，可归因于MRSA的直接医疗成本，包括管理MRSA感染和定居患者的成本以及MRSA基础设施的成本，在2004年平均为8200万美元，到2010年可能达到1.29亿美元。结论：MRSA是一个代价高昂的公共卫生问题，如果加拿大医院和社区要限制这种疾病日益增长的负担，就需要解决这个问题。
BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) has become endemic worldwide in hospitals, and community-associated MRSA is spreading into the community at large.OBJECTIVES: To estimate the current cost of MRSA in Canada and to assess the magnitude of this public health issue.METHODS: An extensive review of the literature was conducted to gather epidemiology, health care resource utilization and cost data for MRSA in Canadian settings. The current MRSA burden was estimated using available cost data and the most recent epidemiology data.RESULTS: The rate of MRSA in Canadian hospitals increased from 0.46 to 5.90 per 1000 admissions between 1995 and 2004, while community-associated MRSA continued to spread into the community. Patients harbouring MRSA required prolonged hospitalization (average 26 days of isolation per patient), special control measures, expensive treatments and extensive surveillance. Total cost per infected MRSA patient averaged $12,216, with hospitalization being the major cost driver (81%), followed by barrier precautions (13%), antimicrobial therapy (4%) and laboratory investigations (2%). The most recent epidemiological data, combined with available cost data, Suggest that direct health care cost attributable to MRSA in Canada, including cost for management of MRSA-infected and colonized patients and MRSA infrastructure, averaged $82 million in 2004 and could reach $129 million in 2010.CONCLUSION: MRSA is a costly public health issue that needs to be tackled if the growing burden of this disease in Canadian hospitals and in the community is to be limited.