MRSA surgical infections exact heavy clinical, financial toll
■ Preventing the resistant staph infection could lower readmission and mortality rates and save hospitals thousands in costs associated with caring for readmitted patients.
Methicillin-resistant Staphylococcus aureus, the hard-to-control superbug, wreaks havoc on the surgical patients who contract it and is a financial burden for hospitals, new research shows.
Compared with patients who go home from surgery uninfected, patients with MRSA infections are 35 times more likely to be readmitted to the hospital and seven times more likely to die within three months, according to a study in the December 2009 PLoS ONE (link). PLoS ONE is a multidisciplinary, peer-reviewed journal published by the nonprofit Public Library of Science.
The study also found that patients infected with MRSA after surgery spent an additional three weeks in the hospital and cost $60,000 more to care for.
"My experience as a doctor for over 30 years is that these infections, once they develop, are just terribly hard to get rid of," said Daniel J. Sexton, MD, senior author of the study. "When you add the time -- every day in the hospital is extraordinarily expensive, and so is every readmission -- you do the simple arithmetic on that, and you get a big number."
Dr. Sexton and his colleagues studied outcomes for 659 surgical patients at one tertiary care center and six community hospitals affiliated with the Duke Infection Control Outreach Network, a collaboration of Duke University School of Medicine in North Carolina and 35 hospitals nationwide. Dr. Sexton directs the network.
Of the 150 patients who contracted MRSA surgical infections, 25 died within 90 days and 110 were readmitted. The median hospital charge was nearly $80,000. Dr. Sexton said the clinical and cost effectiveness of preventive measures such as screening high-risk patients for MRSA colonization before surgery is unclear. But, he added, understanding the costs of inaction is key to saving money and protecting patients.
"We constantly encounter people who say we can't afford this or we can't afford that -- it's too expensive," said Dr. Sexton, an infectious disease specialist and professor of medicine at Duke. "The missing part of the equation is what's the expense of not doing anything. ... People have got to set their priorities and look at their resources, but just accepting the status quo can lose a lot of money and hurt a lot of patients."