Effective MRSA Screening to improve patient safety and reduce costs

By Mary Jo Deal

Methicillin-Resistant Staphylococcus aureus (MRSA) is a problematic pathogen and a leading cause of healthcare-associated infections (HAI). To combat the spread of MRSA, active surveillance is often part of a multidisciplinary infection prevention program. This approach is aimed at reducing the associated morbidity, mortality, and systemic costs of HAIs. A closer look into the active surveillance tests can illustrate how effective laboratory testing can impact patient safety and financial outcomes.

“A closer look into the active surveillance tests can illustrate how effective laboratory testing can impact patient safety and financial outcomes.”
-Mary Jo Deal

Clinicians have been trained to look for high sensitivity and specificity as key performance indicators of laboratory tests. While these indicators are important, an additional parameter to performance is the predictive value of a laboratory test, specifically Positive Predictive Value (PPV) and Negative Predictive Value (NPV). Predictive value is essential because it is a measure of the likelihood that a positive test result indicates disease, or a negative test result may rule out disease. Low PPV translates into more false positive results, while low NPV translates into more false negative results. Both affect proper treatment and handling of a patient. Clinicians, Infection Prevention, and administration want to know, given a specific test result, the probability of disease or in this case MRSA colonization. This relates to the predictive value of the test.

Depending on a hospital's patient isolation strategy to prevent the spread of MRSA, an MRSA screening test may result in a patient being moved in or out of isolation. So what happens if a patient is falsely categorized as MRSA-colonized? They may be unnecessarily placed in isolation with contact precautions, utilizing precious resources without reducing transmission of the infectious agent. Often, the positive MRSA colonization result is captured on medical records and is a red flag upon patient readmission to the hospital causing another chain of costly events for treating negative patients as MRSA-colonized. Ultimately, the incorrect screening result leads to a much greater financial burden and risk to the patient as well as the healthcare provider. By selecting a screening test with a high PPV, hospitals can correctly detect patients colonized with MRSA, execute appropriate isolation protocols, and implement contact precautions to aid in the prevention and control of MRSA.

Thermo Fisher Scientific offers a chromogenic media for the detection of MRSA colonization, Remel Spectra^TM MRSA, which offers the highest PPV currently on the market. With many different products available, it can be a daunting task to determine the best solution for your institution.

In order to better understand the systemic financial implications of MRSA screening and the costs for isolation, an independent health economist has developed the MRSA Screening Cost Analyzer to review all commercial chromogenic media and PCR methods for detecting MRSA nasal colonization. The MRSA Screening Cost Analyzer takes into account specific parameters of different screening populations, MRSA colonization rate, isolation costs, and the screening test costs. Additionally, the MRSA Screening Cost Analyzer is the first of its kind to look at unnecessary isolation costs and their deleterious effect on the hospital system. A demonstration of this tool can be seen at www.remel.com/hai, and a demonstration with your specific hospital data can be performed by a Remel Technical Sales Representative.

The mission of Thermo Fisher Scientific is to enable customers to make the world healthier, cleaner, and safer. In today's healthcare environment, every decision involves a calculated risk to ensure patient safety with appropriate financial outcomes. The best decision is made when epidemiological data and hospital costs are involved to determine how your institution's goals and objectives can be achieved. Only then can the human and financial impact be appropriately managed.

Biography

Mary Jo Deal is Vice President and General Manager for Thermo Fisher Scientific, Microbiology Americas. She has held numerous positions in the IVD industry including Senior VP Marketing and Sales for Hycor Biomedical as well as positions with Dade International (now Siemens Healthcare Diagnostics) and Abbott Diagnostics. She holds a BS in Chemistry and a PhD in Biochemistry.