Clinical outcomes and costs due to Staphylococcus aureus bacteremia among patients receiving long-term hemodialysis.

OBJECTIVE: To examine the clinical outcomes and costs associated with Staphylococcus aureus bacteremia 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 with S. aureus bacteremia. 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 treating S. aureus bacteremia, including readmissions and outpatient costs, was $24,034 per episode. The mean initial hospitalization cost was significantly greater for patients with complicated versus uncomplicated S. aureus bacteremia ($32,462 vs $17,011; P = .002). CONCLUSION: Interventions to decrease the rate of S. aureus bacteremia are needed in this high-risk, hemodialysis-dependent population.

Duke Scholars

Author Vance Garrison Fowler Jr. Medicine, Infectious Diseases

Author Gordon Ralph Corey Medicine, Infectious Diseases

Author Shelby Derene Reed Population Health Sciences

Author Lyman Barth Reller Pathology