Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Kyoto City, Kyoto, Japan.
Department of Bacteriology II, National Institute of Infectious Diseases, Musashimurayama City, Tokyo, Japan.
Am J Infect Control. 2018 Oct;46(10):1142-1147. doi: 10.1016/j.ajic.2018.04.214. Epub 2018 May 18.
Methicillin-resistant Staphylococcus aureus (MRSA) is the most common antimicrobial-resistant organism identified in Japanese health care facilities. This study analyzed the clinical and economic burdens attributable to methicillin resistance in S aureus in Japanese hospitals.
We retrospectively investigated data from 14,905 inpatients of 57 hospitals combined with data from nosocomial infection surveillance and administrative claim databases. The participants were inpatients with admission from April 1, 2014, to discharge on March 31, 2016. The outcomes were evaluated according to length of stay, hospital charges, and in-hospital mortality. We compared the disease burden of MRSA infections with methicillin-susceptible S aureus (MSSA) infections based on patients' characteristics and onset periods.
We categorized 7,188 and 7,717 patients into MRSA and MSSA groups, respectively. The adjusted effects of the MRSA group were 1.03-fold (95% confidence interval [CI] 1.01-1.05) and 1.04-fold (95% CI, 1.01-1.06), respectively, with an odds ratio of 1.14 (95% CI, 1.02-1.27).
The results of this study found that patient severity and onset delays were positively associated with both MRSA and burden and that the effect of methicillin resistance remained significant after adjustment.
耐甲氧西林金黄色葡萄球菌（MRSA）是日本医疗机构中最常见的抗微生物药物耐药菌。本研究分析了日本医院中金黄色葡萄球菌耐甲氧西林的临床和经济负担。
我们回顾性调查了来自 57 家医院的 14905 名住院患者的数据，同时结合了医院感染监测和行政索赔数据库的数据。参与者为 2014 年 4 月 1 日至 2016 年 3 月 31 日期间入院的住院患者。根据住院时间、医院费用和院内死亡率来评估结局。我们根据患者特征和发病期比较了 MRSA 感染和甲氧西林敏感金黄色葡萄球菌（MSSA）感染的疾病负担。
我们将 7188 名和 7717 名患者分别归入 MRSA 和 MSSA 组。MRSA 组的调整后影响为 1.03 倍（95%置信区间[CI] 1.01-1.05）和 1.04 倍（95% CI，1.01-1.06），比值比为 1.14（95% CI，1.02-1.27）。
本研究结果发现，患者严重程度和发病延迟与 MRSA 和负担均呈正相关，并且在调整后，耐甲氧西林的影响仍然显著。
