Adverse Clinical and Economic Outcomes Attributable to Methicillin Resistance among Patients with Staphylococcus aureus Surgical Site Infection

• Published in: Clinical infectious diseases Vol. 36; no. 5; pp. 592 - 598
• Main Authors: Engemann, John J., Carmeli, Yehuda, Cosgrove, Sara E., Fowler, Vance G., Bronstein, Melissa Z., Trivette, Sharon L., Briggs, Jane P., Sexton, Daniel J., Kaye, Keith S.
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01.03.2003; University of Chicago Press
• Subjects: Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Bacteremia; Bacterial diseases; Biological and medical sciences; Female; General Surgery; Health outcomes; Hospital Costs; Human bacterial diseases; Humans; Infections; Infectious diseases; Intensive care units; Length of Stay; Lung diseases; Major Articles; Male; Medical sciences; Methicillin Resistance; Middle Aged; Mortality; Outcome Assessment (Health Care) - economics; Pharmacology. Drug treatments; Postoperative Complications - economics; Postoperative Complications - microbiology; Postoperative Complications - mortality; Staphylococcal Infections - economics; Staphylococcal Infections - microbiology; Staphylococcal Infections - mortality; Staphylococcal infections, streptococcal infections, pneumococcal infections; Staphylococcus aureus; Human; Surgical wound; Postoperative; Nosocomial infection; Prognosis; Pathogenesis; β-Lactams; Meticillin; Infection; Penicillin derivatives; Resistance; Antibiotic; Bacteriosis; Bacteria; Micrococcales; Complication; Micrococcaceae; Antibacterial agent; Staphylococcal infection; Staphylococcus aureus
• ISSN: 1058-4838; 1537-6591; 1537-6591
• DOI: 10.1086/367653

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.