Clinical Outcomes and Costs Due toStaphylococcus aureusBacteremia Among Patients Receiving Long-Term Hemodialysis

Abstract

AbstractObjective:To examine the clinical outcomes and costs associated withStaphylococcus aureusbacteremia 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 withS. aureusbacteremia.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 treatingS. aureusbacteremia, including readmissions and outpatient costs, was $24,034 per episode. The mean initial hospitalization cost was significantly greater for patients with complicated versus uncomplicatedS. aureusbacteremia ($32,462 vs $17,011;P= .002).Conclusion:Interventions to decrease the rate of S.aureusbacteremia are needed in this high-risk, hemodialysis-dependent population (Infect Control Hosp Epidemiol2005;26:534-539).