- Oral presentation
- Open Access
Cost-effectiveness of hand hygiene promotion for MRSA blood stream infection in ICU settings
Antimicrobial Resistance and Infection Control volume 4, Article number: O50 (2015)
Multimodal interventions are effective in increasing hand hygiene compliance amongst healthcare workers, but it is not known whether such interventions are cost-effective outside high-income countries.
To determine whether reductions in Methicillin-resistant Staphylococcus aureus bloodstream infections (MRSA-BSI) alone would make hand hygiene interventions cost-effective in intensive care units (ICUs) in a middle-income country using a model-based framework.
Transmission dynamic and decision analytic models were combined to determine the expected impact of hand hygiene interventions on MRSA-BSI incidence and evaluate their cost-effectiveness. Epidemiological and economic parameters were derived using data from a tertiary hospital in North-east Thailand. Sensitivity analyses were performed with different values for MRSA transmissibility and colonization prevalence on admission.
Interventions increasing hand hygiene compliance from a 10% baseline to ≥20% are likely to be cost-effective solely through reduced MRSA-BSI. Increasing compliance from 10% to 40% was estimated to cost $US 89·1 per bed-year with 4·07 QALYs gained per 10,000 bed-days in the paediatric ICU (PICU) and $US 63·3 per bed-year with 4·03 QALYs gained per 10,000 bed-days in the adult ICU. If baseline compliance is not greater than 20%, the intervention is always cost-effective even with only a 10% compliance improvement.
Effective multimodal hand hygiene interventions are likely to be cost-effective in ICU settings in typical middle-income countries where baseline compliance is low due to preventing MRSA-BSI alone. Where compliance is higher, the cost-effectiveness of interventions to improve it further will depend on the impact on HAIs other than MRSA-BSI.
Disclosure of interest
Rights and permissions
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
About this article
Cite this article
Luangasanatip, N., Hongsuwan, M., Lubell, Y. et al. Cost-effectiveness of hand hygiene promotion for MRSA blood stream infection in ICU settings. Antimicrob Resist Infect Control 4 (Suppl 1), O50 (2015). https://doi.org/10.1186/2047-2994-4-S1-O50
- Bloodstream Infection
- Hand Hygiene
- Decision Analytic Model
- Transmission Dynamic
- Blood Stream Infection