QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Résumé Extracto Full Text PDF Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Articles Ahead of Print [Order Reprint] Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kopp, B. J Articles by Armstrong, E. P Search for Related Content PubMed PubMed Citation Articles by Kopp, B. J Articles by Armstrong, E. P

INFECTIOUS DISEASES

Clinical and Economic Analysis of Methicillin-Susceptible and -Resistant Staphylococcus aureus Infections

Clinical Pharmacist, Adult Critical Care, Department of Pharmacy Practice and Science, College of Pharmacy, University of Arizona, Tucson, AZ

David E Nix, PharmD

Associate Professor, Department of Pharmacy Practice and Science, College of Pharmacy, University of Arizona

Edward P Armstrong, PharmD

Professor, Department of Pharmacy Practice and Science, College of Pharmacy, University of Arizona

Reprints: Brian J Kopp PharmD, Department of Pharmacy Practice and Science, College of Pharmacy, University of Arizona, 1703 E. Mabel St., Tucson, AZ 85721-0207, fax 520/694-5164, kopp{at}pharmacy.arizona.edu

BACKGROUND: The rate of methicillin-resistant Staphylococcus aureus (MRSA) has increased significantly over the last decade. Previous cohort studies of patients with MRSA bacteremia have reported higher mortality rates, increased morbidity, longer hospital length of stay (LOS), and higher costs compared with patients with methicillin-susceptible S. aureus (MSSA) bacteremia. The clinical and economic impact of MRSA involving other sites of infection has not been well characterized.

OBJECTIVE: To determine the clinical and economic implications of MRSA compared with MSSA infections across a variety of infection sites and severity of illnesses.

METHODS: A retrospective, case–control analysis comparing differences in clinical and economic outcomes of patients with MRSA and MSSA infections was conducted at an academic medical center. Case patients with MRSA infection were matched (1:1 ratio) to control patients with MSSA infection according to age, site of infection, and type of care.

RESULTS: Thirty-six matched pairs of patients with S. aureus infection were identified. Baseline characteristics of patients with MSSA and MRSA infection were similar. Patients with MRSA infections had a trend toward longer hospital LOS (15.5 vs 11 days; p = 0.05) and longer antibiotic-related LOS (10 vs 7 days; p = 0.003). Median hospital cost associated with treatment of patients with MRSA infections was higher compared with patients with MSSA infections ($16 575 vs $12 862; p = 0.11); however, this difference was not statistically significant. Treatment failure was common in patients with MRSA infection. Among patients with MSSA infections, treatment failure was associated with vancomycin use.

CONCLUSIONS: Patients with MRSA infections had worse clinical and economic outcomes compared with patients with MSSA infections.

Key Words: methicillin resistance, Staphylococcus aureus

Published Online, July 20, 2004. www.theannals.com, DOI 10.1345/aph.1E028

This article has been cited by other articles:

				A. M. Elward, J. M. McAndrews, and V. L. Young Methicillin-Sensitive and Methicillin-Resistant Staphylococcus aureus: Preventing Surgical Site Infections Following Plastic Surgery Aesthetic Surgery Journal, May 1, 2009; 29(3): 232 - 244. [Abstract] [Full Text] [PDF]

				Z. Athanassa, I. I. Siempos, and M. E. Falagas Impact of methicillin resistance on mortality in Staphylococcus aureus VAP: a systematic review Eur. Respir. J., March 1, 2008; 31(3): 625 - 632. [Abstract] [Full Text] [PDF]

				A. K. Baranwal, S. C. Singhi, and M. Jayashree A 5-year PICU Experience of Disseminated Staphylococcal Disease, Part 1: Clinical and Microbial Profile J Trop Pediatr, August 1, 2007; 53(4): 245 - 251. [Abstract] [Full Text] [PDF]

				O. Oluola, L. Kong, M. Fein, and L. E. Weisman Lysostaphin in Treatment of Neonatal Staphylococcus aureus Infection Antimicrob. Agents Chemother., June 1, 2007; 51(6): 2198 - 2200. [Abstract] [Full Text] [PDF]

				A. T. Curns, R. C. Holman, J. J. Sejvar, M. F. Owings, and L. B. Schonberger Infectious Disease Hospitalizations Among Older Adults in the United States From 1990 Through 2002 Arch Intern Med, November 28, 2005; 165(21): 2514 - 2520. [Abstract] [Full Text] [PDF]

				D. Flayhart, J. F. Hindler, D. A. Bruckner, G. Hall, R. K. Shrestha, S. A. Vogel, S. S. Richter, W. Howard, R. Walther, and K. C. Carroll Multicenter Evaluation of BBL CHROMagar MRSA Medium for Direct Detection of Methicillin-Resistant Staphylococcus aureus from Surveillance Cultures of the Anterior Nares J. Clin. Microbiol., November 1, 2005; 43(11): 5536 - 5540. [Abstract] [Full Text] [PDF]

				A. M. Bressler, T. Williams, E. E. Culler, W. Zhu, D. Lonsway, J. B. Patel, and F. S. Nolte Correlation of Penicillin Binding Protein 2a Detection with Oxacillin Resistance in Staphylococcus aureus and Discovery of a Novel Penicillin Binding Protein 2a Mutation J. Clin. Microbiol., September 1, 2005; 43(9): 4541 - 4544. [Abstract] [Full Text] [PDF]

				K. Poole Efflux-mediated antimicrobial resistance J. Antimicrob. Chemother., July 1, 2005; 56(1): 20 - 51. [Abstract] [Full Text] [PDF]