Estimating the disease burden of methicillin-resistant Staphylococcus aureus in Japan: Retrospective database study of Japanese hospitals.
Estimating the disease burden of methicillin-resistant Staphylococcus aureus in Japan: Retrospective database study of Japanese hospitals.
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DOI：
10.1371/journal.pone.0179767
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Imanaka Y
中科院分区：
文献类型：
--
作者：
Uematsu H;Yamashita K;Kunisawa S;Fushimi K;Imanaka Y
抗菌素耐药性感染对日本各地医疗机构的全国性影响尚未得到检查。这项研究旨在评估日本医院耐甲氧西林金黄色葡萄球菌(MRSA)感染的疾病负担。对有和没有MRSA感染的住院患者的结果进行了回顾分析。一个全国性的行政索赔数据库。日本全国有1133家急救医院。2014年4月1日至2015年3月31日期间出院的所有外科和非外科住院患者。疾病负担通过住院费用、住院时间和住院死亡率进行评估。使用一种独特的感染识别方法，我们根据抗MRSA药物使用情况将患者分为抗MRSA药物组和对照组。为了估计MRSA感染的负担，我们计算了这两组之间结果测量的差异。这些估计被外推到日本所有采用预期付费系统的1584家急性护理医院。我们将93 838例患者归入抗MRSA药物组，2181 827例患者归入对照组。抗MRSA药物组的平均住院费用、住院天数和住院死亡率分别为33548美元、75.7天和22.9%，分别是对照组的3.43倍、2.95倍和3.66倍。当推算到1584家医院时，MRSA增加的总负担估计为20亿美元(占总住院费用的3.41%)，434万天(占总住院时间的3.02%)，以及1430万人死亡(占总死亡率的3.62%)。这项研究量化了日本MRSA感染的大致疾病负担。这些发现可以让政策制定者了解抗菌素耐药性感染的负担，并支持感染预防计划的应用。
The nationwide impact of antimicrobial-resistant infections on healthcare facilities throughout Japan has yet to be examined. This study aimed to estimate the disease burden of methicillin-resistant Staphylococcus aureus (MRSA) infections in Japanese hospitals. Retrospective analysis of inpatients comparing outcomes between subjects with and without MRSA infection. A nationwide administrative claims database. 1133 acute care hospitals throughout Japan. All surgical and non-surgical inpatients who were discharged between April 1, 2014 and March 31, 2015. Disease burden was assessed using hospitalization costs, length of stay, and in-hospital mortality. Using a unique method of infection identification, we categorized patients into an anti-MRSA drug group and a control group based on anti-MRSA drug utilization. To estimate the burden of MRSA infections, we calculated the differences in outcome measures between these two groups. The estimates were extrapolated to all 1584 acute care hospitals in Japan that have adopted a prospective payment system. We categorized 93 838 patients into the anti-MRSA drug group and 2 181 827 patients into the control group. The mean hospitalization costs, length of stay, and in-hospital mortality of the anti-MRSA drug group were US$33 548, 75.7 days, and 22.9%, respectively; these values were 3.43, 2.95, and 3.66 times that of the control group, respectively. When extrapolated to the 1584 hospitals, the total incremental burden of MRSA was estimated to be US$2 billion (3.41% of total hospitalization costs), 4.34 million days (3.02% of total length of stay), and 14.3 thousand deaths (3.62% of total mortality). This study quantified the approximate disease burden of MRSA infections in Japan. These findings can inform policymakers on the burden of antimicrobial-resistant infections and support the application of infection prevention programs.