Outcomes of Staphylococcus aureus infection in hemodialysis-dependent patients.
OBJECTIVE
Staphylococcus aureus is a leading cause of infection in patients with ESRD. Clinical and economic outcomes associated with S. aureus bacteremia and other S. aureus infections in patients with ESRD were examined.


METHODS
Laboratory, clinical, and hospital billing data from a randomized trial of 3359 hemodialysis-dependent patients hospitalized with S. aureus infection in the United States whose vascular access type was fistula or graft and who were hospitalized with S. aureus infection to evaluate inpatient costs, hospital days, and mortality over 12 wk were used. Generalized linear regression was used to identify independent predictors of 12-wk costs, inpatient days, and mortality.


RESULTS
Of the 279 patients (8.3%) who developed S. aureus infection during approximately 1 yr of follow-up, 25.4% were treated as outpatients. Among patients for whom billing data were available, 89 patients hospitalized with S. aureus bacteremia incurred mean 12-wk inpatient costs of $19,454 and 11.9 inpatient days. Among the 70 patients hospitalized with non-bloodstream S. aureus infections, mean inpatient costs were $19,222 and the mean number of inpatient days was 11.3. Twelve-week mortality was 20.2 and 15.7% for patients with S. aureus bloodstream and non-bloodstream infections, respectively. Older age was independently associated with higher risk of death among patients with S. aureus bacteremia and with higher inpatient costs and more hospital days among patients with non-bloodstream infections.


CONCLUSIONS
Hemodialysis-dependent patients with fistula or graft access incur high costs and long inpatient stays when hospitalized for S. aureus infection.
Li
Yanhong
Y
Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina, USA.
Friedman
Joëlle Y
JY
O'Neal
Betsy F
BF
Hohenboken
Matthew J
MJ
Griffiths
Robert I
RI
Stryjewski
Martin E
ME
Middleton
John P
JP
Schulman
Kevin A
KA
Inrig
Jula K
JK
Fowler
Vance G
VG
Reed
Shelby D
SD
D000367:Age Factors; D000368:Aged; D001166:Arteriovenous Shunt, Surgical / Q000191:economics; D019917:Blood Vessel Prosthesis Implantation / Q000191:economics; D004311:Double-Blind Method; D005260:Female; D017721:Hospital Costs; D017052:Hospital Mortality; D006801:Humans; D007297:Inpatients; D007676:Kidney Failure, Chronic / Q000191:economics / Q000382:microbiology / Q000401:mortality / Q000628:therapy*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care / Q000191:economics; D010045:Outpatients; D006435:Renal Dialysis / Q000009:adverse effects / Q000191:economics; D018570:Risk Assessment; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000191:economics / Q000382:microbiology / Q000517:prevention & control*; D013209:Staphylococcal Vaccines; D013211:Staphylococcus aureus / Q000472:pathogenicity*; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
D013209:Staphylococcal Vaccines