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Clinical Outcomes and Costs Due to Staphylococcus aureus Bacteremia Among Patients Receiving Long-Term Hemodialysis

Published online by Cambridge University Press:  21 June 2016

John J. Engemann*
Affiliation:
Division of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, North Carolina
Joëlle Y. Friedman
Affiliation:
Center for Clinical and Genetic Economics, Duke University Medical Center, Durham, North Carolina Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
Shelby D. Reed
Affiliation:
Center for Clinical and Genetic Economics, Duke University Medical Center, Durham, North Carolina Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
Robert I. Griffiths
Affiliation:
Health Economics Consulting, Annapolis, Maryland
Lynda A. Szczech
Affiliation:
Division of Nephrology, Department of Medicine, Duke University Medical Center, Durham, North Carolina Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
Keith S. Kaye
Affiliation:
Division of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, North Carolina
Martin E. Stryjewski
Affiliation:
Division of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, North Carolina Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
L. Barth Reller
Affiliation:
Division of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, North Carolina Clinical Microbiology Laboratory, Department of Pathology, Duke University Medical Center, Durham, North Carolina
Kevin A. Schulman
Affiliation:
Center for Clinical and Genetic Economics, Duke University Medical Center, Durham, North Carolina Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
G. Ralph Corey
Affiliation:
Division of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, North Carolina Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
Vance G. Fowler Jr.
Affiliation:
Division of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, North Carolina Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
*
Box 3038, Duke University Medical Center, Durham, NC 27710.john.engemann@duke.edu

Abstract

Objective:

To examine the clinical outcomes and costs associated with Staphylococcus aureus bacteremia among hemodialysis-dependent patients.

Design:

Prospectively identified cohort study.

Setting:

A tertiary-care university medical center in North Carolina.

Patients:

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).

Conclusion:

Interventions to decrease the rate of S. aureus bacteremia are needed in this high-risk, hemodialysis-dependent population (Infect Control Hosp Epidemiol 2005;26:534-539).

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2005

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