Lodise Thomas P, McKinnon Peggy S
Department of Pharmacy Practice, Albany College of Pharmacy, Albany, NY 12208, USA.
Diagn Microbiol Infect Dis. 2005 Jun;52(2):113-22. doi: 10.1016/j.diagmicrobio.2005.02.007.
We performed a retrospective cohort study to determine the morbidity, mortality, and hospital costs attributable to methicillin resistance in patients with S. aureus bacteremia (SAB). Episodes of SAB occurring at the Detroit Receiving Hospital in 1999-2001 were evaluated. Controlling for confounding variables, patients with methicillin-resistant Staphylococcus aureus (MRSA) had a 1.5-fold longer length of stay (19.1 versus 14.2 days, P = 0.005) and a 2-fold increased cost of hospitalization (dollar 21577 versus dollar 11668, P = 0.001) compared with methicillin-susceptible S. aureus (MSSA). MRSA patients were at increased risk for delayed treatment, and delayed therapy was an independent predictor of mortality. Efforts should be made to ensure that appropriate therapy is initiated promptly in patients at risk for MRSA. Infection control policies must be strictly enforced to limit the spread of MRSA and potentially minimize excess hospital expenditures incurred with MRSA. With the advent of new treatment options, the impact of MRSA will need to be revisited to determine if these therapies can remedy the increased morbidity associated with MRSA.
我们进行了一项回顾性队列研究，以确定金黄色葡萄球菌菌血症（SAB）患者中耐甲氧西林所致的发病率、死亡率和住院费用。对1999 - 2001年在底特律接收医院发生的SAB病例进行了评估。在控制混杂变量后，耐甲氧西林金黄色葡萄球菌（MRSA）感染的患者与甲氧西林敏感金黄色葡萄球菌（MSSA）感染的患者相比，住院时间延长了1.5倍（19.1天对14.2天，P = 0.005），住院费用增加了2倍（21577美元对11668美元，P = 0.001）。MRSA感染患者延迟治疗的风险增加，而延迟治疗是死亡率的独立预测因素。应努力确保对有MRSA感染风险的患者及时开始适当治疗。必须严格执行感染控制政策，以限制MRSA的传播，并可能将因MRSA导致的额外医院支出降至最低。随着新治疗方案的出现，需要重新审视MRSA的影响，以确定这些疗法是否能够纠正与MRSA相关的发病率增加的问题。
