The burden of methicillin-resistant staphylococcus aureus infections among hospitalised patients in singapore

Abstract

Background: MRSA has caused enormous burden to affected Western patients and society. However, only limited study results originated from the Asia-Pacific populations. Aim: To assess the burden of Methicillin-resistant S. aureus infections (MRSA) among patients from a large tertiary care hospital in Singapore. Methods: Retrospective study using data from the hospital discharge database to identify patients with MRSA and Methicillin-sensitive S. aureus infections (MSSA) using International Statistical Classification of Diseases and Related Health Problems, 9th Revision, Australian Modification (ICD-9-AM) codes.   Findings: Amongst 543,068 hospitalized patients between 2004 and 2010, 8,664(1.6%) were infected with S. Aureus, including 4,868(0.9%) with MRSA. Compared with uninfected controls, MRSA patients had longer hospital stay (geometric mean, GM, 12.2 vs. 3.0 days), higher hospitalization costs (GM, $6294.7 vs. $2295.7), higher in-hospital mortality rate (7.8% vs. 2.8%) and higher 30-day all-cause unscheduled readmission rate (36.3% vs. 23.7%, all p<0.001). The difference still existed after adjustment for age groups, gender, ethnicity, medical management, and Charlson comorbidity index. Similarly, MRSA patients had longer hospital stay, higher hospitalization costs, higher in-hospital mortality rate and 30-day all-cause unscheduled readmission rate compared with patients with MSSA. Conclusion: MRSA infection was associated with poor clinical outcomes and higher economic burden in this population. Prevention and control measures should be implemented both inside and outside the hospital setting.