{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T03:40:23Z","timestamp":1791344423510,"version":"4.3.1"},"reference-count":36,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2015,1,2]],"date-time":"2015-01-02T00:00:00Z","timestamp":1420156800000},"content-version":"unspecified","delay-in-days":1737,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2010,4]]},"abstract":"<jats:sec id=\"S0195941700038303_abs1\"><jats:title>Objective.<\/jats:title><jats:p>To determine differences in healthcare costs between cases of methicillin-susceptible <jats:italic>Staphylococcus aureus<\/jats:italic> (MSSA) infection and methicillin-resistant <jats:italic>S. aureus<\/jats:italic> (MRSA) infection in adults.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700038303_abs2\"><jats:title>Design.<\/jats:title><jats:p>Retrospective study of all cases of <jats:italic>S. aureus<\/jats:italic> infection.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700038303_abs3\"><jats:title>Setting.<\/jats:title><jats:p>Department of Veterans Affairs hospital and associated clinics.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700038303_abs4\"><jats:title>Patients.<\/jats:title><jats:p>There were 390 patients with MSSA infections and 335 patients with MRSA infections.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700038303_abs5\"><jats:title>Methods.<\/jats:title><jats:p>We used medical records, accounting systems, and interviews to identify services rendered and costs for Minneapolis Veterans Affairs Medical Center patients with S. <jats:italic>aureus<\/jats:italic> infection with onset during the period from January 1, 2004, through June 30, 2006. We used regression analysis to adjust for patient characteristics.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700038303_abs6\"><jats:title>Results.<\/jats:title><jats:p>Median 6-month unadjusted costs for patients infected with MRSA were $34,657, compared with $15,923 for patients infected with MSSA. Patients with MRSA infection had more comorbidities than patients with MSSA infection (mean Charlson index 4.3 vs 3.2; <jats:italic>P<\/jats:italic> &lt; .001). For patients with Charlson indices of 3 or less, mean adjusted 6-month costs derived from multivariate analysis were $51,252 (95% CI, $46,041\u2013$56,464) for MRSA infection and $30,158 (95% CI, $27,092\u2013$33,225) for MSSA infection. For patients with Charlson indices of 4 or more, mean adjusted costs were $84,436 (95% CI, $79,843\u2013$89,029) for MRSA infection and $59,245 (95% CI, $56,016\u2013$62,473) for MSSA infection. Patients with MRSA infection were also more likely to die than were patients with MSSA infection (23.6% vs 11.5%; <jats:italic>P<\/jats:italic> &lt; .001). MRSA infection was more likely to involve the lungs, bloodstream, and urinary tract, while MSSA infection was more likely to involve bones or joints; eyes, ears, nose, or throat; surgical sites; and skin or soft tissue (<jats:italic>P<\/jats:italic> &lt; .001).<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700038303_abs7\"><jats:title>Conclusions.<\/jats:title><jats:p>Resistance to methicillin in S. <jats:italic>aureus<\/jats:italic> was independently associated with increased costs. Effective antimicrobial stewardship and infection prevention programs are needed to prevent these costly infections.<\/jats:p><\/jats:sec>","DOI":"10.1086\/651094","type":"journal-article","created":{"date-parts":[[2010,2,25]],"date-time":"2010-02-25T09:12:34Z","timestamp":1267089154000},"page":"365-373","source":"Crossref","is-referenced-by-count":138,"title":["Excess Costs and Utilization Associated with Methicillin Resistance for Patients with <i>Staphylococcus aureus<\/i> Infection"],"prefix":"10.1017","volume":"31","author":[{"given":"Gregory A.","family":"Filice","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John A.","family":"Nyman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Lexau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine H.","family":"Lees","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsay A.","family":"Bockstedt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Como-Sabetti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsey J.","family":"Lesher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth","family":"Lynfield","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2015,1,2]]},"reference":[{"key":"S0195941700038303_ref019","volume-title":"Performance Standards for Antimicrobial Susceptibility Testing","year":"2002"},{"key":"S0195941700038303_ref035","doi-asserted-by":"publisher","DOI":"10.1086\/510393"},{"key":"S0195941700038303_ref034","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.153"},{"key":"S0195941700038303_ref029","doi-asserted-by":"publisher","DOI":"10.1086\/519473"},{"key":"S0195941700038303_ref026","volume-title":"Econometric Analysis.","author":"Greene","year":"2003"},{"key":"S0195941700038303_ref022","doi-asserted-by":"publisher","DOI":"10.1016\/S0167-6296(01)00086-8"},{"key":"S0195941700038303_ref020","unstructured":"Department of Veterans Affairs. Veterans Health Information Systems and Technology Architecture (VistA)\u2014description. Washington, DC: Department of Veterans Affairs. http:\/\/www.virec.research.va.gov\/DataSourcesName\/VISTA\/VistA.htm. 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VHA Decision Support System (DSS)\u2014Introduction. 2008. http:\/\/www.virec.research.va.gov\/DataSourcesName\/DSS\/DSSintro.htm. 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