Graduate School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia; Department of Infectious Diseases, Wollongong Hospital, Wollongong, New South Wales, Australia.
School of Psychology, University of Wollongong, Wollongong, New South Wales, Australia.
J Hosp Infect. 2022 Nov;129:41-48. doi: 10.1016/j.jhin.2022.07.004. Epub 2022 Jul 14.
Staphylococcus aureus is associated with significant mortality and increased burden on the healthcare system. Relatively few reliable estimates are available regarding the impact of meticillin-resistant S. aureus (MRSA) infection compared with meticillin-susceptible S. aureus (MSSA) infection.
To compare patients with MRSA infection and MSSA infection to identify differences in inpatient mortality, length of stay and costs of hospital services, and identify predictors of MRSA as a cause of S. aureus infection.
An analytical, retrospective, longitudinal study using non-identifiable linked data on adults admitted to hospitals of a health district in Australia with a diagnosis of S. aureus infection over a 10-year period. The main outcome measure was 30-day inpatient mortality. Secondary endpoints included total overnight stays, all-cause inpatient mortality, and hospitalization costs within 1 year of index admission.
Inpatient mortality at 30, 100 and 365 days was estimated to be significantly greater for patients with MRSA infection. The mean additional cost of MRSA infection when controlling for additional factors was $5988 and 4 nights of additional hospital stay per patient within 1 year of index admission. Key predictors of MRSA infection were: date of index admission; higher comorbidity score; greater socio-economic disadvantage; admission to hospital other than via the emergency department; older age; and prior admission to hospital within 28 days of index admission.
MRSA infection is associated with increased inpatient mortality, costs and hospital length of stay compared with MSSA infection. Efforts are required to alleviate the additional burden of MRSA infection on patients and healthcare systems.
金黄色葡萄球菌与高死亡率和增加医疗系统负担相关。与耐甲氧西林金黄色葡萄球菌（MRSA）感染相比，有关甲氧西林敏感金黄色葡萄球菌（MSSA）感染的可靠估计相对较少。
比较 MRSA 感染和 MSSA 感染患者，以确定住院患者死亡率、住院时间和医院服务成本的差异，并确定 MRSA 作为金黄色葡萄球菌感染的原因的预测因素。
使用澳大利亚一个卫生区住院患者的不可识别链接数据进行分析性、回顾性、纵向研究，这些患者在 10 年内诊断为金黄色葡萄球菌感染。主要结局测量指标为 30 天住院患者死亡率。次要结局指标包括总住院时间、所有原因的住院患者死亡率和指数入院后 1 年内的住院费用。
MRSA 感染患者的 30 天、100 天和 365 天住院患者死亡率估计显著更高。在控制其他因素后，MRSA 感染的平均额外成本为 5988 美元，并且每个患者在指数入院后 1 年内额外住院 4 晚。MRSA 感染的主要预测因素包括：指数入院日期；更高的合并症评分；更大的社会经济劣势；非急诊部门入院；年龄较大；以及在指数入院前 28 天内曾住院。
与 MSSA 感染相比，MRSA 感染与住院患者死亡率、成本和住院时间延长相关。需要努力减轻 MRSA 感染对患者和医疗保健系统的额外负担。
