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Hospital stays for MRSA staph infections
1993 though 2005
Senior Citizen Health & Medicine
MRSA Staph Infection Hits Senior Citizens Hardest, Hospitalizations
Up 10 Fold Since 1995
Superbug hospitalizations in 2005 were 3 times over 2000, up 30% in
just one year
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Rates of hospitalization with MRSA infection per
100,000 population, by age group, 2004
Source: AHRQ, Center for Delivery, Organization, and
Markets, Healthcare Cost and Utilization Project, Nationwide Inpatient
Sample, 2004
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Nov. 7, 2007 - Its commonly just referred to as MRSA or
sometimes as the superbug. The terrible reality is that it is an
infectious disease with the ability to fight off attempts to kill it
with antibiotics and it is crawling across the America, escaping from
its normal habitat in healthcare facilities and striking thousands of
senior citizens three times as many as any other age group.
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Health & Medicine |
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There were 368,000 hospitalizations in 2005 for
MRSA, which was ten times larger than 1995 and even triple the number in
just 2000. It was a 30 percent jump over 2004.
The highest rate of MRSA hospitalization was among
the elderly - 360.8 of every 100,000 hospital stays were for MRSA
treatment.
This was more than three times higher than for any
other age group:
>19.2 for 1- to 17-year-olds,
>58.1 for 18- to 44-year-olds, and
> 111.5 for 45- to 64-year-olds per 100,000.
These are just some of the facts released in a
statistical report, Infections with Methicillin-Resistant
Staphylococcus Aureus (MRSA) in U.S. Hospitals, 19932005, from
Healthcare Cost and Utilization Project of the Agency for Healthcare
Research and Quality. Authors are Anne Elixhauser, Ph.D. and Claudia
Steiner, M.D., M.P.H.
Infections with methicillin-resistant
Staphylococcus aureus (MRSA) are resistant to the antibiotics normally
used to treat them (beta-lactam antibiotics, including methicillin,
oxacillin, amoxicillin, and penicillin), according to the brief.
Although Staphylococcus is a common bacterium that
resides on skin and in nasal passages, it can cause infections if it
enters the body through a cut in the skin, and these infections can be
serious.
MRSA infections can occur among hospitalized
patients who under-go surgery or who have suppressed immunity; however,
they also increasingly occur among non-hospitalized patients who are
other-wise healthy, the report says.
The authors say that from current evidence it is
not possible to determine whether these infections originated in the
hospital or were community acquired.
Key Findings
● On average, hospital stays for MRSA infections
cost $14,000, compared with $7,600 for all other stays, and the length
of hospitalization was more than double - 10.0 days for MRSA infections
versus 4.6 days for all other stays.
● MRSA hospitalizations were more likely to begin
in the emergency department, to be trans-fers from another hospital, or
transfers from long-term care settings. The in-hospital death rate for
MRSA stays was 4.7 percent compared with 2.1 percent for non-MRSA stays.
● The most common conditions associated with MRSA
are skin infections (18.9 percent of all MRSA cases), pneumonia (9.0
percent), complications of medical care (about 16 percent), and
septicemia (7.3 percent).
● Hospital stays for MRSA infections were highest
in the South where there were 113.2 MRSA hospitalizations per 100,000
population. In the West, there were 95.9 MRSA stays, and in the Midwest
and Northeast, there were about 89 MRSA stays per 100,000.
● Figure 1 shows the growth in MRSA infections
over the 13 years from 1993 to 2005. In 2005, there were about 368,600
cases of MRSA infection in U.S. hospitals, a figure that increased by 30
percent after 2004, more than tripled after 2000, and increased nearly
tenfold after 1995. In 1993, there were fewer than 2,000 MRSA infections
recorded in U.S. hospitals.
Characteristics of patients with MRSA infections
● Overall, 44.0 percent of all hospital
inpatients with MRSA in 2004 were over the age of 65, 27.6 percent were
45 to 64 years old, and 22.2 percent were age 18 to 44.
● Compared with patients without MRSA infections,
a significantly larger proportion of patients in the hospital with MRSA
infections tended to be 45 years and older.
● With respect to gender, only 47.3 percent of
MRSA patients were female compared with 59.0 percent of non-MRSA
patients.
● Parallel to the age distribution, 45.6 percent
of all MRSA hospitalizations were covered by Medicare compared with 32.9
percent of hospital stays during which MRSA was not recorded.
● A significantly smaller proportion of MRSA
patients were covered by private insurance (20.4 percent) compared with
non-MRSA patients (34.5 percent).
● There was no difference in MRSA infection rates
for patients covered by Medicaid and for the uninsured.
● MRSA hospitalizations were more likely to begin
in the emergency department (56.8 percent versus 43.0 percent for
non-MRSA stays), to be transfers from another hospital (5.9 percent
versus 3.5 percent for non-MRSA stays), or transfers from long-term care
settings (4.4 percent versus 1.5 percent for non-MRSA stays).
● The in-hospital death rate for MRSA
hospitalizations was more than double that for non-MRSA-stays (4.7
percent versus 2.1 percent).
Resource use for MRSA hospital stays
● MRSA hospitalizations cost nearly double that
for non-MRSA stays - $14,000 for MRSA stays compared with $7,600 for
non-MRSA stays.
● The average length of stay in the hospital for
a patient with MRSA infection was more than double that for non-MRSA
stays - 10.0 days versus 4.6 days.
Population rates of MRSA hospitalization
● The rate of MRSA infection was highest in the
South where there were 113.2 MRSA-related hospital stays per 100,000
population.
● The next highest rate was in the West with 95.9
stays per 100,000 population.
● The Northeast and the Midwest had comparable
rates of about 89 stays per 100,000 population.
● The rate of MRSA infection was higher for males
than for females - 106.6 stays per 100,000 population for males compared
with 92.2 for females.
● The highest rate of MRSA hospitalization was
for those 65 years and older with 360.8 stays per 100,000. Infants less
than one year of age were the next highest group with 114.7 MRSA stays
per 100,000 population. This group was followed closely by 45 to 64 year
olds who had 111.5 MRSA stays per 100,000 population.
● Patients in the 1 to 17 year age group had the
lowest rate of MRSA infections.
● Parallel to the findings by age, there were
331.6 stays per 100,000 for patients covered by Medicare.
● Patients covered by Medicaid had 184.1 stays
per 100,000, and the uninsured had 43.2 stays per 100,000.
● All these rates were higher than the rate for
the privately insured.
Most common principal diagnoses associated with
MRSA infections
MRSA infection can only appear as a secondary
diagnosis; the principal diagnosis provides information on the main
reason for admission to the hospital.
● Five of the top 10 principal conditions were
related to infections - skin and subcutaneous infections and pneumonia
(the two most common conditions), septicemia, infective arthritis and
osteomyelitis, and urinary tract infections.
● The third and fourth most common conditions
represented complications of medical care (about 16 percent of MRSA
cases).
● Complications from diabetes ranked seventh (3.3
percent of MRSA cases).
● Also ranked in the top 10 were respiratory
failure (an indication of the seriousness of this condition) and chronic
ulcer of the skin. condition) and chronic ulcer of the skin. All of
these conditions were significantly more common among MRSA patients than
among patients with no MRSA infection.
● All of these conditions were significantly more
common among MRSA patients than among patients with no MRSA infection.
Most common procedures associated with MRSA
infections
● The top two procedures associated with MRSA
infections are related to surgical treatment of skin infection -
incision/drainage and debridement of skin. These procedures were
performed in about 13 percent of cases, many times more frequent than
among non-MRSA patients.
● A third procedure that is likely related to
surgical care of infection was partial excision of the bone, accounting
for 1.4 percent of cases.
● Blood transfusions, respiratory intubation,
hemodialysis, and enteral and parenteral nutrition all signal severe
illness and were performed more frequently for MRSA patients. Several
diagnostic studies were relatively common and more prevalent among MRSA
patients.
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