Adverse clinical and economic outcomes attributable to methicillin resistance among patients with Staphylococcus aureus surgical site infection

被引:685
作者
Engemann, JJ [1 ]
Carmeli, Y
Cosgrove, SE
Fowler, VG
Bronstein, MZ
Trivette, SL
Briggs, JP
Sexton, DJ
Kaye, KS
机构
[1] Duke Univ, Med Ctr, Div Infect Dis, Dept Med, Durham, NC 27710 USA
[2] Duke Univ, Med Ctr, Dept Infect Control, Durham, NC 27710 USA
[3] Durham Reg Hosp, Dept Infect Control, Durham, NC USA
[4] Beth Israel Deaconess Med Ctr, Div Infect Dis, Boston, MA 02215 USA
[5] Harvard Univ, Sch Med, Boston, MA USA
[6] Johns Hopkins Univ Hosp, Dept Med, Baltimore, MD 21287 USA
关键词
D O I
10.1086/367653
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 [免疫学];
摘要
Data for 479 patients were analyzed to assess the impact of methicillin resistance on the outcomes of patients with Staphylococcus aureus surgical site infections (SSIs). Patients infected with methicillin-resistant S. aureus (MRSA) had a greater 90-day mortality rate than did patients infected with methicillin-susceptible S. aureus (MSSA; adjusted odds ratio, 3.4; 95% confidence interval, 1.5-7.2). Patients infected with MRSA had a greater duration of hospitalization after infection (median additional days, 5; P<.001), although this was not significant on multivariate analysis (P=.11). Median hospital charges were $29,455 for control subjects, $52,791 for patients with MSSA SSI, and $92,363 for patients with MRSA SSI (P<.001 for all group comparisons). Patients with MRSA SSI had a 1.19-fold increase in hospital charges (P=.03) and had mean attributable excess charges of $13,901 per SSI compared with patients who had MSSA SSIs. Methicillin resistance is independently associated with increased mortality and hospital charges among patients with S. aureus SSI.
引用
收藏
页码:592 / 598
页数:7
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