Аннотация
Переведена и печатается с согласия авторов и редакции журнала «Emerging Infectious Diseases» 1999;5:9-17. На основе статистической информации из больниц и прейскуранта медицинских услуг за 1995 г., полученных в отделе здравоохранения Нью-Йорка, подсчитано общее число госпитализированных больных, летальных исходов и прямых медицинских расходов, связанных с инфекциями, вызванными Staphylococcus aureus. Сопоставлены расходы на лечение внебольничных и госпитальных инфекций, вызванных метициллинорезистентными и чувствительными штаммами S.aureus. У пациентов с инфекциями, вызванными S.aureus, продолжительность госпитализации, стоимость лечения и летальность были в 2 раза выше, чем у пациентов, госпитализированных в связи с другими инфекциями. Расходы на терапию метициллинорезистентных и чувствительных штаммов золотистого стафилококка значительно не отличались, однако летальность от инфекций, вызванных резистентными штаммами, была больше (соответственно 21 и 8%). При одинаковой летальности от внебольничных и госпитальных инфекций непосредственные медицинские расходы на лечение одного пациента с внебольничными инфекциями были выше (соответственно 35 300 и 28 800 долларов США). Результаты исследования показывают, что уменьшение частоты внутрибольничных инфекций, вызванных метициллинорезистентными и чувствительными штаммами S.aureus, приведет к снижению медицинских расходов.
-
1.
Haley R.W., Culver D.H., White J.W., Morgan W.M., Emori T.G. The nationwide nosocomial infection rate: a new need for vital statistics. Am J Epidemiol 1985; 121:159.
-
2.
Pittet D., Tarara D., Wenzel R.P. Nosocomial bloodstream infection in critically ill patients, excess length of stay, extra costs, and attributable mortality. JAMA 1994; 271:1598-601.
-
3.
Brachman P.S., Dan B.B., Haley R.W., Hooten T.M., Garner J.S., Allen J.R. Nosocomial surgical infections: incidence and cost. Surg Clin North Am 1980; 60:15-25.
-
4.
Centers for Disease Control and Prevention. National Nosocomial Infection Surveillance System report: data summary from October 1986 – April 1996. Atlanta (GA): U.S. Department of Health and Human Services; 1996.
-
5.
Neu H.C. The crisis in antibiotic resistance. Science 1992;257:1064-72.
-
6.
Barrett F.F., McGehee R.F., Finland M. Methicillin-resistant Staphylococcus aureus at Boston City hospital. N Engl J Med 1968;279:441.
-
7.
Boyce J.M. Increasing prevalence of methicillin-resistant Staphylococcus aureus in the United States. Infect Control Hosp Epidemiol 1990;11:639-42.
-
8.
Panlilio A.L., Culver D.H., Gaynes R.P., Banerjee S., Henderson T.S., Tolson J.S., et al. Methicillin-resistant Staphylococcus aureus in U.S. hospitals, 1975–1991. Infect Control Hosp Epidemiol 1992;13:582-6.
-
9.
Nosocomial enterococci resistant to vancomycin – United States, 1989–1993. MMWR Morb Mortal Wkly Rep 1993;42:597-9.
-
10.
Recommendations for preventing the spread of vancomycin resistance. Recommendations of the Hospital Infection Control Practices Advisory Committee. MMWR Morb Mortal Wkly Rep 1995;44(RR12):1-13.
-
11.
Reduced susceptibility of Staphylococcus aureus to vancomycin – Japan, 1996. MMWR Morb Mortal Wkly Rep 1997;46:624-6.
-
12.
Update: Staphylococcus aureus with reduced susceptibility to vancomycin in United States, 1997. MMWR Morb Mortal Wkly Rep 1997;46:813-5.
-
13.
Boyce J.M., Jackson M.M., Pugliese G., Batt M.D., Fle-ming D., Garner J.S., et al. Methicillin-resistant Staphylococcus aureus (MRSA): a briefing for acute care hospitals and nursing facilities. Infect Control Hosp Epidemiol 1994;15:105-15.
-
14.
McManus A.T., Mason A.D., McManus W.F., Pruitt B.A. What’s in a name? Is methicillin-resistant Staphylococcus aureus just another S. aureus when treated with vancomycin? Arch Surg 1989; 124:1456-9.
-
15.
Pittet D., Waldvogel F.A. To control or not to control colonization with MRSA ... that’s the question! QJM 1997;90:239-41.
-
16.
Teare E.L., Barrett S.P. Stop the ritual of tracing colonised people. BMJ 1997;314:665-6.
-
17.
Cookson B. Controversies: is it time to stop searching for MRSA? Screening is still important. BMJ 1997;314:664-5.
-
18.
Casewell M.W. New threats to the control of methicillin-resistant Staphylococcus aureus. J Hosp Infect 1995;30 Suppl:465-71.
-
19.
Jarvis W.R. Selected aspects of the socioeconomic impact of nosocomial infections: morbidity, mortality, cost, and prevention. Infect Control Hosp Epidemiol 1996;17:552-7.
-
20.
Haley R.W., White J.W., Culver D.H., Hughes J.M. The financial incentive for hospitals to prevent nosocomial infections under the prospective payment system: an empirical determination from a nationally representative sample. JAMA 1987;257:1611-4.
-
21.
Wakefield D.S., Pfaller M.A., Hammons G.T., Massanari R.M. Use of the appropriateness evaluation protocol for estimating the incremental costs associated with nosocomial infections. Med Care 1987;25:481-8.
-
22.
Jemigan J.A., Clemence M.A., Stott G.A., Titus M.G., Alexander C.H., Palumbo C.M., et al. Control of methicillin-resistant Staphylococcus aureus at a university hospital. Infect Control Hosp Epidemiol 1995;16:668-96.
-
23.
Wakefield D.S., Helms C.M., Massanari R.M., Mori M., Pfaller M. Cost of nosocomial infection: relative contributions of laboratory, antibiotic and per diem costs in serious Staphylococcus aureus infections. Am J Infect Control 1988;16:185-92.
-
24.
Frieden T.R., Fujiwara P.I., Washko R.M., Hamburg M.A. Tuberculosis in New York City – turning the tide. N Engl J Med 1995;333:229-33.
-
25.
Frieden T.R., Munsiff S.S., Low D.E., Willey B.M., Wil-liams G., Faur Y., et al. Emergence of vancomycin-resistant enterococci in New York City. Lancet 1993;342:76-9.
-
26.
New York State Department of Health. 1995 Statewide Planning and Research Cooperative System (SPARCS) Administratively Releasable File. Albany (NY): The Department; 1997.
-
27.
Health Care Financing Administration. Physician fee schedule (CY 1995); payment policies and relative value adjustments. Federal Register 1994;59(235):63410-635.
-
28.
1995 Drug Topics Red Book. Montvale (NJ): Medical Economics Company; 1995.
-
29.
International classification of diseases, 9th revision, clinical modifier: with color symbols: ICD-9-CM. 4th ed. Salt Lake City (UT): Medicode Publications; 1994.
-
30.
Lautenschlager S., Herzog C., Zimmerh W. Course and outcome of bacteremia due to Staphylococcus aureus: evaluation of different clinical case definitions. Clin Infect Dis 1993;16:567-73.
-
31.
Espersen F. Identifying the patient risk for Staphylococcus aureus bloodstream infections. J Chemother 1995;7:11-7.
-
32.
Muder R., Brennen C., Wagener M., Goetz A. Bacteremia in a long-term care facility: a five year prospective study of 163 consecutive episodes. Clin Infect Dis 1992; 14:647-54.
-
33.
Mandell G.I., Bennett J.E., Dolin R., editors. Mandell, Douglas and Bennett’s principles and practices of infectious diseases. 4th ed. New York: Churchill Livingstone; 1995.
-
34.
Lavery L.A., Sariaya M., Ashry H., Harkless L.B. Microbiology of osteomyelitis in diabetic foot ulcers. J Foot Ankel Surg 1995;34:61-4.
-
35.
Isselbacher K.J., Braunwald E., Wilson J.D., Martin J.B., Fauci A.S., Kasper D.L., editors. Harrison’s principles of internal medicine. 13th ed. New York: McGraw-Hill, Inc.; 1994.
-
36.
Fagon J.Y., Chastre J., Vuagnat A., Troillet J.L., Novara A., Gibert C. Nosocomial pneumonia and mortality among patients in intensive care units. JAMA 1996;275:866-9.
-
37.
Papazian L., Bregeon F., Thirion X., Gregoire R., Saux P., Denis J.P., et al. Effect of ventilator-associated pneumonia on mortality and morbidity. Am J Respir Crit Care Med 1996;154:91-7.
-
38.
Fagon J.Y., Chastre J., Hance A.J., Montravers P., Novara A., Gibert C. Nosocomial pneumonia in ventilated patients: a cohort study evaluating attributable mortality and hospital stay. Am J Med 1993;94:281-8.
-
39.
Leu H.S., Kaiser D.L., Mori M., Woolson R.F., Wenzel R.P. Hospital-acquired pneumonia: attributable mortality and morbidity. Am J Epidemiol 1989;129:1258-67.
-
40.
Craven P.C. Treating bone and joint infections with teicoplanin: hospitalization vs. outpatient cost issues. Hospital Formulary 1993;28:41-5.
-
41.
Alien R. Cost-effectiveness issues for home IV therapy in the United States. Hospital Formulary 1993;28:37-40.
-
42.
Amow P.M., Quimosing E.M., Beach M. Consequences of intravascular catheter sepsis. Clin Infect Dis 1993;16:778-84.
-
43.
Agency for Health Care Policy and Research. The HCUP-3 Nationwide Inpatient Sample (NIS), Release 2, 1993. Springfield (VA): National Technical Information Service; 1996.
-
44.
Bradley S.F. Methicillin-resistant Staphylococcus aureus infection. Clin Geriatr Med 1992;8:853-68.
-
45.
McEvoy G.K., editor. American hospital formulary service drug information 1997. Bethesda (MD): American Society of Health-System Pharmacists; 1997.
-
46.
Spink W.W. Staphylococcal infections and the problem of antibiotic-resistant staphylococci. Arch Int Med 1954;94:167-96.
-
47.
Alien J.D., Roberts C.E., Kirby W.M. Staphylococcal septicemia treated with methicillin: report of twenty-two cases. N Engl J Med 1962;266:111-6.