Evaluating the effectiveness and cost effectiveness of MRSA control strategies
Julie Robotham, Project Leader - Health Economist, The Health Protection Agency, The Centre for Infections

Healthcare-associated infections, such as methicillin-resistant Staphylococcus aureus (MRSA) present a considerable threat to public health, both in terms of the morbidity and mortality of patients but also in terms of the logistic and economic burden for healthcare services.

A number of infection control options exist, including: screening for MRSA positive patients; isolation of patients (from single rooms to simply using gloves and gowns); and topical decolonisation with antibiotics or antiseptics. However, how best to control MRSA is still undetermined and the evidence on the effectiveness of each of these interventions is inconclusive. As a result, practices vary from hospital to hospital.

Here, we use existing evidence (from literature, analysis of individual patient level data and formally elicited expert opinion) to model the transmission and control of MRSA. Using this transmission model we evaluate the cost-effectiveness of a number of interventions, comparing the changes in health benefits and resource use associated with different policies. We concentrate particularly on comparing currently available screening technologies (e.g. chromogenic agars and rapid molecular methods) in conjunction with patient isolation and decolonisation.