JSTOR: Infection Control and Hospital Epidemiology, Vol. 26, No. 2 (February 2005), pp. 166-174

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Published by: The University of Chicago Press on behalf of The Society for Healthcare Epidemiology of America

Article DOI: 10.1086/502522

Stable URL: http://www.jstor.org/stable/10.1086/502522

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Original Articles

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

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Abstract(back to top)

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.

Bibliographic Information(back to top)

The Impact of Methicillin Resistance in Staphylococcus aureus Bacteremia on Patient Outcomes: Mortality, Length of Stay, and Hospital Charges
Sara E. Cosgrove , MD, MS, Youlin Qi , MD, MPH, Keith S. Kaye , MD, MPH, Stephan Harbarth , MD, MS, Adolf W. Karchmer , MD and Yehuda Carmeli , MD, MPH
Infection Control and Hospital Epidemiology
Vol. 26, No. 2 (February 2005) (pp. 166-174)

Author Information(back to top)

Sara E. Cosgrove , MD, MS; Youlin Qi , MD, MPH; Keith S. Kaye , MD, MPH; Stephan Harbarth , MD, MS; Adolf W. Karchmer , MD; Yehuda Carmeli , MD, MPH

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Notes

Dr. Cosgrove is from the Division of Infectious Diseases, Johns Hopkins Medical Institutions, Baltimore, Maryland. Drs. Qi, Karchmer, and Carmeli are from the Division of Infectious Diseases, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, Massachusetts. Dr. Carmeli is also from the Division of Infectious Diseases, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. Dr. Kaye is from the Division of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, North Carolina. Dr. Harbarth is from the Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland.Address reprint requests to Sara E. Cosgrove, MD, MS, Osler 425, The Johns Hopkins Hospital, 600 N. Wolfe St., Baltimore, MD 21287. scosgro1@jhmi.eduPresented in part at the 41st Interscience Conference on Antimicrobial Agents and Chemotherapy; December 16‐19, 2001; Chicago, IL.

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