title: Clinical outcomes and costs due to Staphylococcus aureus bacteremia among patients receiving long-term hemodialysis.
abstract: OBJECTIVE
  To examine the clinical outcomes and costs associated with Staphylococcus aureus bacteremia among hemodialysis-dependent patients.
  
  
  METHODS
  Prospectively identified cohort study.
  
  
  METHODS
  A tertiary-care university medical center in North Carolina.
  
  
  METHODS
  Two hundred ten hemodialysis-dependent adults with end-stage renal disease hospitalized with S. aureus bacteremia.
  
  
  RESULTS
  The majority of the patients (117; 55.7%) underwent dialysis via tunneled catheters, and 29.5% (62) underwent dialysis via synthetic arteriovenous fistulas. Vascular access was the suspected source of bacteremia in 185 patients (88.1%). Complications occurred in 31.0% (65), and the overall 12-week mortality rate was 19.0% (40). The mean cost of treating S. aureus bacteremia, including readmissions and outpatient costs, was $24,034 per episode. The mean initial hospitalization cost was significantly greater for patients with complicated versus uncomplicated S. aureus bacteremia ($32,462 vs $17,011; P = .002).
  
  
  CONCLUSIONS
  Interventions to decrease the rate of S. aureus bacteremia are needed in this high-risk, hemodialysis-dependent population.
authors: Division of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA. john.engemann@duke.edu
authors: John J
authors: JJ
authors: Engemann
authors: Joelle Y
authors: JY
authors: Friedman
authors: Shelby D
authors: SD
authors: Reed
authors: Robert I
authors: RI
authors: Griffiths
authors: Lynda A
authors: LA
authors: Szczech
authors: Keith S
authors: KS
authors: Kaye
authors: Martin E
authors: ME
authors: Stryjewski
authors: L Barth
authors: LB
authors: Reller
authors: Kevin A
authors: KA
authors: Schulman
authors: G Ralph
authors: GR
authors: Corey
authors: Vance G
authors: VG
authors: Fowler
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000553:Ambulatory Care / Q000191:economics; D016470:Bacteremia / Q000191:economics* / Q000209:etiology / Q000401:mortality; D017281:Cost of Illness; D003428:Cross Infection / Q000191:economics* / Q000209:etiology / Q000401:mortality; D005251:Fees, Medical / Q000706:statistics & numerical data; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000628:therapy; D007902:Length of Stay / Q000191:economics; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D010359:Patient Readmission / Q000191:economics; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects*; D013203:Staphylococcal Infections / Q000191:economics* / Q000209:etiology / Q000401:mortality; D013211:Staphylococcus aureus; D016896:Treatment Outcome