The impact of methicillin-resistance in Staphylococcus aureus bacteremia on patient outcomes:: Mortality, length of stay, and hospital charges
The impact of methicillin-resistance in Staphylococcus aureus bacteremia on patient outcomes:: Mortality, length of stay, and hospital charges
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DOI：
10.1086/502522
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发表时间：
2005-02-01
影响因子：
4.5
通讯作者：
Carmeli, Y
中科院分区：
文献类型：
--
作者：
Cosgrove, SE;Qi, YL;Carmeli, Y
目的：评估金黄色葡萄球菌的甲氧西林耐药性对死亡率、住院时间和住院费用的影响。设计：对 1997 年 7 月 1 日至 2000 年 6 月 1 日期间入院的患者进行队列研究，这些患者患有临床显着的金黄色葡萄球菌血流感染。地点：马萨诸塞州波士顿市一家拥有 630 个床位的城市三级护理教学医院。患者：对 348 名金黄色葡萄球菌菌血症患者进行了研究； 96 名患者患有耐甲氧西林金黄色葡萄球菌 (MRSA)。甲氧西林敏感金黄色葡萄球菌 (MSSA) 和 MRSA 患者在金黄色葡萄球菌菌血症发生前的性别、院内感染百分比、住院时间、入住 ICU 和手术方面相似。他们在年龄、合并症和疾病严重程度评分方面存在差异。结果：MRSA 和 MSSA 患者的死亡人数相似（22.9% vs 19.8%；P = 0.53）。 MRSA 患者的金黄色葡萄球菌菌血症后存活患者的中位住院时间和金黄色葡萄球菌菌血症后的中位住院费用均显着增加（7 天 vs 9 天，P = .045；19,212 美元 vs 26,424 美元，P = .008）。经过多变量分析，与 MSSA 菌血症相比，MRSA 菌血症仍然与住院时间增加（1.29 倍；P = .016）和住院费用增加（1.36 倍；P = .017）相关。 MRSA 菌血症的中位归因住院时间为 2 天，中位归因住院费用为 6,916 美元。结论：金黄色葡萄球菌菌血症的甲氧西林耐药性与住院时间和住院费用的显着增加相关（Infect Control Hosp Epidemiol 2005；26：166-174）。
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 (Infect Control Hosp Epidemiol 2005;26:166-174).