| Title of the publication | Costs associated with implementation of a strict policy for controlling spread of highly resistant microorganisms in France |
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| Abstract | Objective To assess costs associated with implementation of a strict ‘search and isolate’ strategy for controlling highly drug-resistant organisms (HDRO). Design Review of data from 2-year prospective surveillance (01/2012 to 12/2013) of HDRO. Setting Three university hospitals located in northern Paris. Methods Episodes were defined as single cases or outbreaks of glycopeptide-resistant enterococci (GRE) or carbapenemase-producing Enterobacteriacae (CPE) colonisation. Costs were related to staff reinforcement, costs of screening cultures, contact precautions and interruption of new admissions. Univariate analysis, along with simple and multiple linear regression analyses, was conducted to determine variables associated with cost of HDRO management. Results Overall, 41 consecutive episodes were included, 28 single cases and 13 outbreaks. The cost (mean±SD) associated with management of a single case identified within and/or 48 h after admission was €4443±11 552 and €11 445±15 743, respectively (p<0.01). In an outbreak, the total cost varied from €14 864 ±17 734 for an episode with one secondary case (€7432±8867 per case) to €136 525 ±151 231 (€12 845±5129 per case) when more than one secondary case occurred. In episodes of single cases, contact precautions and microbiological analyses represented 51% and 30% of overall cost, respectively. In outbreaks, cost related to interruption of new admissions represented 77–94% of total costs, and had the greatest financial impact (R2=0.98, p<0.01). Conclusions In HDRO episodes occurring at three university hospitals, interruption of new admissions constituted the most costly measure in an outbreak situation. |
| DOI | https://doi.org/10.1136/bmjopen-2015-009029 |
| Name of the first author | Birgand, Gabriel |
| Year of publication | 2015 |
| Study design of the publication | Other study design |
| If other study design, please specify | Prospective study |
| Method for data collection and analysis |
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| Quantitative data - Quantitative data were used during the intervention | |
| Scientific references about the intervention or other assessment of the intervention | Haut Conseil de la Santé Publique. Prévention de la transmission croisée des Bactéries Hautement Résistantes aux antibiotiques émergentes (BHRe). 2013 Juillet. http://www.hcsp.fr/explore.cgi/ avisrapportsdomaine?clefr=372 |
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| Sub-sector | Sub-sectors are further units of demarcation within a sector E.g. awareness campaign from veterinarians to cat owners about toxoplasmosis drug resistance and transmission of resistant bacteria: ANIMAL, PETS |
| Subsector (human) |
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| Healthcare delivery |
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