title: Health and economic burden of post-partum Staphylococcus aureus breast abscess.
abstract: OBJECTIVE
  To determine the health and economic burdens of post-partum Staphylococcus aureus breast abscess.
  
  
  METHODS
  We conducted a matched cohort study (N = 216) in a population of pregnant women (N = 32,770) who delivered at our center during the study period from 10/1/03-9/30/10. Data were extracted from hospital databases, or via chart review if unavailable electronically. We compared cases of S. aureus breast abscess to controls matched by delivery date to compare health services utilization and mean attributable medical costs in 2012 United States dollars using Medicare and hospital-based estimates. We also evaluated whether resource utilization and health care costs differed between cases with methicillin-resistant and -susceptible S. aureus isolates.
  
  
  RESULTS
  Fifty-four cases of culture-confirmed post-partum S. aureus breast abscess were identified. Breastfeeding cessation (41%), milk fistula (11.1%) and hospital readmission (50%) occurred frequently among case patients. Breast abscess case patients had high rates of health services utilization compared to controls, including high rates of imaging and drainage procedures. The mean attributable cost of post-partum S. aureus breast abscess ranged from $2,340-$4,012, depending on the methods and data sources used. Mean attributable costs were not significantly higher among methicillin-resistant vs. -susceptible S. aureus cases.
  
  
  CONCLUSIONS
  Post-partum S. aureus breast abscess is associated with worse health and economic outcomes for women and their infants, including high rates of breastfeeding cessation. Future study is needed to determine the optimal treatment and prevention of these infections.
authors.affiliation: Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States of America ; Division of Infection Control/Hospital Epidemiology. Silverman Institute for Health Care Quality and Safety, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States of America.
authors.forename: Westyn
authors.initials: W
authors.lastname: Branch-Elliman
authors.forename: Grace M
authors.initials: GM
authors.lastname: Lee
authors.forename: Toni H
authors.initials: TH
authors.lastname: Golen
authors.forename: Howard S
authors.initials: HS
authors.lastname: Gold
authors.forename: Linda M
authors.initials: LM
authors.lastname: Baldini
authors.forename: Sharon B
authors.initials: SB
authors.lastname: Wright
mesh_terms: D000038:Abscess / Q000191:economics* / Q000453:epidemiology / Q000382:microbiology; D016022:Case-Control Studies; D015331:Cohort Studies; D017281:Cost of Illness; D005260:Female; D017048:Health Care Costs; D006296:Health Services / Q000191:economics; D006801:Humans; D008413:Mastitis / Q000191:economics* / Q000453:epidemiology / Q000382:microbiology; D017063:Outcome Assessment, Health Care; D049590:Postpartum Period; D011247:Pregnancy; D013203:Staphylococcal Infections / Q000191:economics* / Q000453:epidemiology; D013211:Staphylococcus aureus
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