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Clinical Outcomes and Costs Due to Staphylococcus aureus Bacteremia Among Patients Receiving Long‐Term Hemodialysis

John J. Engemann , MD, Joëlle Y. Friedman , MPA, Shelby D. Reed , PhD, Robert I. Griffiths , MS, ScD, Lynda A. Szczech , MD, MSCE, Keith S. Kaye , MD, MPH, Martin E. Stryjewski , MD, L. Barth Reller , MD, Kevin A. Schulman , MD, G. Ralph Corey , MD and Vance G. Fowler , Jr., MD, MHS
Infection Control and Hospital Epidemiology
Vol. 26, No. 6 (June 2005), pp. 534-539
DOI: 10.1086/502580
Stable URL: http://www.jstor.org/stable/10.1086/502580
Page Count: 6
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Clinical Outcomes and Costs Due to Staphylococcus aureus Bacteremia Among Patients Receiving Long‐Term Hemodialysis
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Abstract

OBJECTIVE:.  To examine the clinical outcomes and costs associated with Staphylococcus aureus bacteremia among hemodialysis‐dependent patients. DESIGN:.  Prospectively identified cohort study. SETTING:.  A tertiary‐care university medical center in North Carolina. PATIENTS:.  Two hundred ten hemodialysis‐dependent adults with end‐stage renal disease hospitalized with S. aureus bacteremia. RESULTS:.  The majority of the patients (117; 55.7%) underwent dialysis via tunneled catheters, and 29.5% (62) underwent dialysis via synthetic arteriovenous fistulas. Vascular access was the suspected source of bacteremia in 185 patients (88.1%). Complications occurred in 31.0% (65), and the overall 12‐week mortality rate was 19.0% (40). The mean cost of treating S. aureus bacteremia, including readmissions and outpatient costs, was $24,034 per episode. The mean initial hospitalization cost was significantly greater for patients with complicated versus uncomplicated S. aureus bacteremia ($32,462 vs $17,011; P = .002). CONCLUSION.  Interventions to decrease the rate of S. aureus bacteremia are needed in this high‐risk, hemodialysis‐ dependent population.

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