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The Impact of Methicillin Resistance in Staphylococcus aureus Bacteremia on Patient Outcomes: Mortality, Length of Stay, and Hospital Charges

Published online by Cambridge University Press:  21 June 2016

Sara E. Cosgrove ,
Youlin Qi ,
Keith S. Kaye ,
Stephan Harbarth ,
Adolf W. Karchmer  and
Yehuda Carmeli
Sara E. Cosgrove*
Affiliation:
Division of Infectious Diseases, Johns Hopkins Medical Institutions, Baltimore, Maryland
Youlin Qi
Affiliation:
Division of Infectious Diseases, Beth Israel Deaconess Medical Center, andHarvard Medical School, Boston, Massachusetts
Keith S. Kaye
Affiliation:
Division of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, North Carolina
Stephan Harbarth
Affiliation:
Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland
Adolf W. Karchmer
Affiliation:
Division of Infectious Diseases, Beth Israel Deaconess Medical Center, andHarvard Medical School, Boston, Massachusetts
Yehuda Carmeli
Affiliation:
Division of Infectious Diseases, Beth Israel Deaconess Medical Center, andHarvard Medical School, Boston, Massachusetts Division of Infectious Diseases, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
*
Osler 425, The Johns Hopkins Hospital, 600 N. Wolfe St., Baltimore, MD 21287.[email protected]
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Abstract

Objective:

To evaluate the impact of methicillin resistance in Staphylococcus aureus on mortality, length of hospitalization, and hospital charges.

Design:

A cohort study of patients admitted to the hospital between July 1, 1997, and June 1, 2000, who had clinically significant S. aureus bloodstream infections.

Setting:

A 630-bed, urban, tertiary-care teaching hospital in Boston, Massachusetts.

Patients:

Three hundred forty-eight patients with S. aureus bacteremia were studied; 96 patients had methicillin-resistant S. aureus (MRSA). Patients with methicillin-susceptible S. aureus (MSSA) and MRSA were similar regarding gender, percentage of nosocomial acquisition, length of hospitalization, ICU admission, and surgery before S. aureus bacteremia. They differed regarding age, comorbidities, and illness severity score.

Results:

Similar numbers of MRSA and MSSA patients died (22.9% vs 19.8%; P = .53). Both the median length of hospitalization after S. aureus bacteremia for patients who survived and the median hospital charges after S. aureus bacteremia were significantly increased in MRSA patients (7 vs 9 days, P = .045; $19,212 vs $26,424, P = .008). After multivariable analysis, compared with MSSA bacteremia, MRSA bacteremia remained associated with increased length of hospitalization (1.29 fold; P = .016) and hospital charges (1.36 fold; P = .017). MRSA bacteremia had a median attributable length of stay of 2 days and a median attributable hospital charge of $6,916.

Conclusion:

Methicillin resistance in S. aureus bacteremia is associated with significant increases in length of hospitalization and hospital charges.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 26 , Issue 2 , February 2005 , pp. 166 - 174
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2005

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