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Evaluating the cost implications of integrating SARS-CoV-2 genome sequencing for infection prevention and control investigation of nosocomial transmission within hospitals

Panca, Monica; Blackstone, James; Stirrup, Oliver; Cutino-Moguel, Maria-Teresa; Thomson, Emma; Peters, Christine; Snell, Luke B; ... Breuer, Judith; + view all (2023) Evaluating the cost implications of integrating SARS-CoV-2 genome sequencing for infection prevention and control investigation of nosocomial transmission within hospitals. Journal of Hospital Infection 10.1016/j.jhin.2023.06.005. (In press). Green open access

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Abstract

OBJECTIVES: The COG-UK hospital-onset COVID-19 infection (HOCI) trial evaluated the impact of SARS-CoV-2 whole genome sequencing (WGS) on acute infection, prevention, and control (IPC) investigation of nosocomial transmission within hospitals. We estimated the cost implications of using the information from the sequencing reporting tool (SRT), used to determine likelihood of nosocomial infection in IPC practice. METHODS: We conducted a micro-costing approach for SARS-CoV-2 WGS. Data on IPC management resource use and costs were collected from interviews with IPC teams from 14 participating sites and used to assign cost estimates for IPC activities as collected in the trial. Activities included IPC specific actions following a suspicion of healthcare-associated infection (HAI) or outbreak, as well as changes to practice following the return of data via SRT. RESULTS: The mean per sample costs of SARS-CoV-2 sequencing was estimated at £77.10 for rapid and £66.94 for longer turnaround phases. Over the 3 months interventional phases, the total management cost of IPC-defined HAIs and outbreak events across the sites was estimated at £225,070 and £416,447, respectively. Main cost drivers were bed-day lost due to wards closures because of outbreaks followed by outbreak meetings and bed-day lost due to cohorting contacts. Actioning SRTs, the cost of HAIs increased by £5,178 due to unidentified cases and the cost of outbreaks lowered by £11,246 as SRTs excluded hospital outbreaks. CONCLUSIONS: Although, SARS-CoV-2 WGS adds to the total IPC management cost, additional information provided could balance out the additional cost, depending on identified design improvements and effective deployment.

Type: Article
Title: Evaluating the cost implications of integrating SARS-CoV-2 genome sequencing for infection prevention and control investigation of nosocomial transmission within hospitals
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.jhin.2023.06.005
Publisher version: https://doi.org/10.1016/j.jhin.2023.06.005
Language: English
Additional information: This version is the version of record. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: COVID-19, SARS-CoV-2, cost, healthcare-associated infection, infection prevention and control, micro-costing
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology > Comprehensive CTU at UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health > Infection and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/10171942
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