National Costs Associated With Methicillin-Susceptible and Methicillin-Resistant Staphylococcus aureus Hospitalizations in the United States, 2010–2014. (12th May 2018)

• Record Type: Journal Article
• Authors: Klein, Eili Y; Jiang, Wendi; Mojica, Nestor; Tseng, Katie K; McNeill, Ryan; Cosgrove, Sara E; Perl, Trish M
• Is Part Of: Clinical infectious diseases. Volume 68:Number 1(2019)
• Page Start: 22
• Page End: 28
• Publication Date: 2018-05-12
• Subjects: hospitalization costs -- national inpatient sample -- excess cost of resistant infections -- propensity score–adjusted costs -- antimicrobial resistance; Communicable diseases -- Periodicals; 616.905
• DOI: 10.1093/cid/ciy399
• Languages: English
• ISSNs: 1058-4838

Abstract

Abstract : Prior research found that costs for methicillin-resistant Staphylococcus aureus (MRSA) infections were greater than methicillin-susceptible (MSSA) infections. However, analysis of recent US national hospitalization data found that costs for MSSA infections are the same or greater than MRSA infections. Abstract: Background: Infections caused by methicillin-resistant Staphylococcus aureus (MRSA) have been associated with worse patient outcomes and higher costs of care than methicillin-susceptible (MSSA) infections. However, since prior studies found these differences, the healthcare landscape has changed, including widespread dissemination of community-associated strains of MRSA. We sought to provide updated estimates of the excess costs of MRSA infections. Methods: We conducted a retrospective analysis using data from the National Inpatient Sample from the Agency for Healthcare Research and Quality for the years 2010–2014. We calculated costs for hospitalizations, including MRSA- and MSSA-related septicemia and pneumonia infections, as well as MRSA- and MSSA-related infections from conditions classified elsewhere and of an unspecified site ("other infections"). Differences in the costs of hospitalization were estimated using propensity score–adjusted mortality outcomes for 2010–2014. Results: In 2014, estimated costs were highest for pneumonia and sepsis-related hospitalizations. Propensity score–adjusted costs were significantly higher for MSSA-related pneumonia ($40725 vs $38561; P = .045) and other hospitalizations ($15578 vs $14792; P < .001) than for MRSA-related hospitalizations. Similar patterns were observed from 2010 to 2013, although crude cost differences between MSSA- and MRSA-related pneumonia hospitalizations rose from 25.8% in 2010 to 31.0% in 2014. Compared with MSSA-related hospitalizations, MRSA-related hospitalizations had a higher adjusted mortality rate. Conclusions: Although MRSA infections had been previously associated with higher hospitalization costs, our results suggest that, in recent years, costs associated with MSSA-related infections have converged with and may surpass costs of similar MRSA-related hospitalizations.