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 Mauldin, P. D Articles by Bosso, J. A Search for Related Content PubMed PubMed Citation Articles by Mauldin, P. D Articles by Bosso, J. A

INFECTIOUS DISEASES

Nosocomial Infections Due to Methicillin-Resistant Staphylococcus aureus and Vancomycin-Resistant Enterococcus: Relationships with Antibiotic Use and Cost Drivers

Associate Professor, Department of Clinical Pharmacy and Outcome Sciences, College of Pharmacy, Medical University of South Carolina, Charleston, SC; Health Research Scientist, Ralph H Johnson Veterans Affairs Medical Center, Charleston

Cassandra D Salgado, MD MS

Assistant Professor, Division of Infectious Diseases, College of Medicine, Medical University of South Carolina

Valerie L Durkalski, PhD

Assistant Professor, Department of Biostatistics, Bioinformatics, and Epidemiology, Medical University of South Carolina

John A Bosso, PharmD

Professor and Chair, Department of Clinical Pharmacy and Outcome Sciences, South Carolina College of Pharmacy; Professor of Medicine, Division of Infectious Diseases, South Carolina College of Medicine, Medical University of South Carolina

Reprints: Dr. Bosso, Department of Pharmacy and Clinical Sciences, South Carolina College of Pharmacy, Medical University of South Carolina campus, 280 Calhoun St., PO Box 250144, Charleston, SC 29425, fax 843/792-1712, bossoja{at}musc.edu

BACKGROUND: Increased incidence of nosocomial infections due to methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) has been associated with the use of certain antibiotics and has resulted in increased morbidity, mortality, and costs of care.

OBJECTIVE: To describe relationships between vancomycin and linezolid use and incidence of these nosocomial infections over time and to determine factors associated with the increased costs of care (cost drivers) associated with affected patients.

METHODS: The association between institution-wide antibiotic use and the rate of nosocomial MRSA and VRE infections was assessed using segmented regression analysis for interrupted time series. The effect that patient characteristics and procedures, as well as certain antibiotic use, had on costs and length of stay of patients with MRSA or VRE nosocomial infection was also assessed and cost drivers for the 2 types of infections were compared.

RESULTS: Our analysis included 206 patients who developed MRSA (n = 187) or VRE (n = 19) nosocomial infection. Although small numbers of VRE nosocomial infection may limit generalizations from our results, we found no significant relationship between vancomycin or linezolid use and the rate of either infection. While mean hospital costs were similar, cost drivers varied somewhat between infection types.

CONCLUSIONS: The incidence of MRSA or VRE infections does not appear to be related to the use of vancomycin or linezolid. Costs of care are quite high in some affected patients and, while mean total hospital costs are similar, cost drivers appear to differ between the 2 infection types.

Key Words: antibiotic use, cost, methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus

Published Online, February 19, 2008. www.theannals.com, DOI 10.1345/aph.1K501

This article has been cited by other articles:

				P. D. Mauldin, C. D. Salgado, I. S. Hansen, D. T. Durup, and J. A. Bosso Attributable Hospital Cost and Length of Stay Associated with Health Care-Associated Infections Caused by Antibiotic-Resistant Gram-Negative Bacteria Antimicrob. Agents Chemother., January 1, 2010; 54(1): 109 - 115. [Abstract] [Full Text] [PDF]

				K. M. Kuper, E. B. Hirsch, V. H. Tam, and on behalf of the Houston Infectious Diseases Netwo Significant publications on infectious diseases pharmacotherapy in 2008 Am. J. Health Syst. Pharm., October 1, 2009; 66(19): 1726 - 1734. [Abstract] [Full Text] [PDF]

				D. M. Wolk, E. Picton, D. Johnson, T. Davis, P. Pancholi, C. C. Ginocchio, S. Finegold, D. F. Welch, M. de Boer, D. Fuller, et al. Multicenter Evaluation of the Cepheid Xpert Methicillin-Resistant Staphylococcus aureus (MRSA) Test as a Rapid Screening Method for Detection of MRSA in Nares J. Clin. Microbiol., March 1, 2009; 47(3): 758 - 764. [Abstract] [Full Text] [PDF]

				M. K. Oule, R. Azinwi, A.-M. Bernier, T. Kablan, A.-M. Maupertuis, S. Mauler, R. K. Nevry, K. Dembele, L. Forbes, and L. Diop Polyhexamethylene guanidine hydrochloride-based disinfectant: a novel tool to fight meticillin-resistant Staphylococcus aureus and nosocomial infections J. Med. Microbiol., December 1, 2008; 57(12): 1523 - 1528. [Abstract] [Full Text] [PDF]