TABLE 2.

Health care utilization and associated costs for the management of methicillin-resistant Staphylococcus aureus (MRSA) patients in Canada

Study	Health care resource	Unit	Quantity	Unit cost	Cost per patient
Conly, 2003 (41) Tertiary care hospitals British Columbia, Ontario and Quebec Skin and soft tissue infections only	Hospitalization	Days	28.9	Not applicable	Not applicable
	Antimicrobial therapy	Days	22.4	Not applicable	Not applicable
	Intravenous vancomycin	Days	19.5	Not applicable	Not applicable
Kim et al, 2001 (22) Tertiary care hospitals Ontario	Hospitalization	Days	14	$916.83*	$12,835.60*
	Antimicrobial therapy	–	–	–	$574.40*
	Laboratory investigations	Specimen	–	$8.34	$143.60*
	Barrier precautions	Contact	60/day	$0.96	$806.40*
	MRSA surveillance	Specimen	–	$5.50	–
	Total cost/MRSA infection	–	–	–	$14,360.00
	Total cost/MRSA colonization	–	–	–	$1,363.00
Canada Communicable Disease Report, 2002 (24) General hospitals Ontario	Hospitalization	Days	28	$185.00	$5,180.00
	Laboratory investigations	Specimen	21	$15.00	$315.00
	Total barrier precautions*	–	–	–	$1,727.00
	Added nursing time	Days	1.12	$576.00	$645.00
	Gowns and masks	Each	50×28	$0.40	$560.00
	Examination gloves	Each	28	$7.00	$196.00
	Mupirocin ointment masks	Each	3	$15.00	$45.00
	Chlorhexidine gluconate	Bottle	4	$2.35	$9.00
	Environmental cleaning	Days	15.25	$17.82	$272.00
	Total cost to hospital (antimicrobials not included)	–	–	–	$7,222.00
Papia et al, 1999 (25)	Hospitalization†	Days	36	$210.00	$7,560.00
	Laboratory investigations	Specimen	15	$8.34	$125.00
	Total barrier precautions*	–	–	–	$2,086.00
	Added nursing time	Min	60×36	$0.36	$778.00
	Gowns and gloves	Each	60×36	$0.60	$1,296.00
	2% mupirocin	–	–	–	$7.40
	4% chlorhexidine gluconate	–	–	–	$5.04
	Total cost to hospital (antimicrobials not included)	–	–	–	$9,771.00
Rosner et al, 2004 (26) Model based on data from tertiary care hospitals British Columbia, Ontario, Quebec Skin and soft tissue infections only	Hospitalization	Days	21.4–23.4	$401.00	$6,191.00–$6,979.00
	Antimicrobial therapy	Days	21.1–20.8	–	$325.00–$358.00
	Professional fees	–	–	–	$509.00–$984.00
	Outpatient intravenous antimicrobial	–	–	–	$74.00–$370.00
	Outpatient oral antimicrobial	–	–	–	$0–$378.00
	Home intravenous care service	–	–	–	$12.00–$227.00
	Total cost to Ministry of Health and Long-term Care	–	–	–	$7,693.00–$8,444.00
Bryce et al, 2000 (27) Tertiary care hospital British Columbia	Hospitalization	–	–	–	$6,500.00
	Laboratory investigations and barrier precautions	–	–	–	$4,345.00
	Total cost to hospital (antimicrobial not included)	–	–	–	$10,845.00
Gardam et al, 2001 (23) University-affiliated laboratory Ontario	Total cost – protocol MSA-4	Specimen	–	–	$3.83
	Laboratory cost	Specimen	–	–	$1.33
	Laboratory technologist cost	Specimen	–	–	$2.50
	Total cost – protocol M-SAM	Specimen	–	–	$8.05–$9.30
	Laboratory cost	Specimen	–	–	$4.31
	Laboratory technologist cost	Specimen	–	–	$3.74–$4.99

^*Numbers calculated from data available in published document;

^†Daily cost per room was $210; costs included in the estimate by Papia et al were only those incurred by the hospital ($84), assuming that 60% were recovered from the patient. M-ASM Broth-containing protocol as recommended by the American Society for Microbiology;

MSA-4 Mannitol-salt agar containing 4 μg/mL of oxacillin