多重耐药菌主动筛查成本效益分析

Cost-benefit analysis of active surveillance culture of multi-drug-resistant organism

目的研究多重耐药菌主动筛查的成本效益,为其在临床推广和制定有效的感染控制措施提供依据。方法将2011年11月1日至2012年4月30日入住深圳市中医院ICU的患者设为对照组,共79例,采用常规细菌培养方法对其进行耐甲氧西林金黄色葡萄球菌(MRSA)检测;将2012年6月1日至2012年11月30日入住ICU的患者设为干预组,共86例,采用快速可靠的MRSA产色培养基,对其进行MRSA主动筛查。对比两组MRSA检出率,并进行成本效益分析。结果干预组与对照组在入、出ICU时MRSA携带率差异无统计学意义(P>0.05)。干预组住院时间较对照组短(t=2.39,P<0.05),直接医疗费用、疾病经济负担较对照组少,可获得1.19的效益成本比。结论选用MRSA产色培养基开展主动筛查,可以为及时实施接触隔离预防措施提供循证依据,更有利于接触预防措施落实到位,缩短患者住院时间,降低经济负担。

Objective To analysis the cost-benefit of active surveillance culture of multi-drug resistant organism, and provide a theoretical basis and reference for clinical application of active surveillance. Methods Compared the colonization ratio of MRSA about ICU patients with two methods, active surveillance culture with MRSA petri dish and traditional microbial culture. Results The colonization ratios of MRSA about ICU patients about active surveillance culture （intervention group） and traditional microbial culture （control group） had no difference, weather at admission or at discharge. The hospitalization days of intervention group were shorter than those of control group （t = 2.39, P 〈 0.05）. Implementation of active surveillance culture of multi-drug resistant organism could reduce the disease economic burden. The cost-benefit ratio was 1.19. Conclusion Active surveillance culture with MRSA petri dish can provide evidence for contact isolation, and smooth the implementation of such isolation. The implementation of active surveillance culture can reduce hospitalization days and save cost.