title: The economic burden of methicillin-resistant Staphylococcus aureus in community-onset pneumonia inpatients.
abstract: The quantitative effect of multidrug-resistant bacterial infections on real-world health care resources is not clear. This study aimed to estimate the burden of methicillin-resistant Staphylococcus aureus (MRSA) infections in pneumonia inpatients in Japan.
  
  
  
  Using a nationwide administrative claims database, we analyzed pneumonia patients who had been hospitalized in 1,063 acute care hospitals. Patients who received anti-MRSA drugs were categorized into an anti-MRSA drug group, and the remaining patients comprised the control group. We estimated the burden of length of stay, in-hospital mortality, total antibiotic agent costs, and total hospitalization costs. Risk adjustments were conducted using propensity score matching.
  
  
  
  The study sample comprised 634 patients administered anti-MRSA drugs and 87,427 control patients. In propensity score-matching analysis (1 to 1), the median length of stay, antibiotic costs, and hospitalization costs of the anti-MRSA drug group were significantly higher than those of the control group (21 days vs 14 days [P < .001], $756 vs $172 [P < .001] and $8,741 vs $5,063 [P < .001], respectively); the attributable excess of these indicators were 9.0 ± 1.6 days, $1,044 ± $101, and $5,548 ± $580, respectively.
  
  
  
  These findings may serve as a reference to support further research on multidrug-resistant bacterial infections and eventually inform policy formulation.
authors.affiliation: Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Kyoto City, Kyoto, Japan.
authors.forename: Hironori
authors.initials: H
authors.lastname: Uematsu
authors.affiliation: Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Kyoto City, Kyoto, Japan.
authors.forename: Kazuto
authors.initials: K
authors.lastname: Yamashita
authors.affiliation: Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Kyoto City, Kyoto, Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Kunisawa
authors.affiliation: Department of Health Policy and Informatics, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Kiyohide
authors.initials: K
authors.lastname: Fushimi
authors.affiliation: Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Kyoto City, Kyoto, Japan. Electronic address: imanaka-y@umin.net.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Imanaka
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017714:Community-Acquired Infections / Q000191:economics* / Q000453:epidemiology* / Q000382:microbiology; D017281:Cost of Illness; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007902:Length of Stay; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D008875:Middle Aged; D011023:Pneumonia, Staphylococcal / Q000191:economics* / Q000453:epidemiology* / Q000382:microbiology; D016019:Survival Analysis
keywords: Clinical and economic burden; Infection; MRSA; Propensity score matching