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

  • Sara E. Cosgrove (a1), Youlin Qi (a2), Keith S. Kaye (a3), Stephan Harbarth (a4), Adolf W. Karchmer (a2) and Yehuda Carmeli (a2) (a5)...
Abstract
Abstract<span class='bold'>Objective:</span>

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

<span class='bold'>Design:</span>

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.

<span class='bold'>Setting:</span>

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

<span class='bold'>Patients:</span>

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.

<span class='bold'>Results:</span>

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.

<span class='bold'>Conclusion:</span>

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

Copyright
Corresponding author
Osler 425, The Johns Hopkins Hospital, 600 N. Wolfe St., Baltimore, MD 21287.scosgro1@jhmi.edu
References
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Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
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