The burden of nosocomial staphylococcus aureus bloodstream infection in South Korea: a prospective hospital-based nationwide study

Abstract

BACKGROUND: We estimated the nationwide burden of nosocomial S. aureus

bloodstream infection (SA-BSI), a major cause of nosocomial infection, in South

Korea. METHODS: To evaluate the nationwide incidence of nosocomial SA-BSI, cases

of SA-BSI were prospectively collected from 22 hospitals with over 500 beds over

4?months. Data on patient-days were obtained from a national health insurance

database containing the claims data for all healthcare facilities in South Korea.

The additional cost of SA-BSI was estimated through a matched case?control study.

The economic burden was calculated from the sum of the medical costs, the costs

of caregiving and loss of productivity. RESULTS: Three hundred and thirty nine

cases of nosocomial SA-BSI were included in the study: 254 cases of

methicillin-resistant SA-BSI (MRSA-BSI) and 85 cases of methicillin-susceptible

SA-BSI (MSSA-BSI). Death related to BSI occurred in 81 cases (31.9%) of MRSA-BSI

and 12 cases (14.1%) of MSSA-BSI. The estimated incidence of nosocomial MRSA-BSI

was 0.12/1,000 patient-days and that of nosocomial MSSA-BSI, 0.04/1,000

patient-days. The estimated annual cases of nosocomial BSI were 2,946 for MRSA

and 986 for MSSA in South Korea. The additional economic burden per case of

nosocomial SA-BSI was US $20,494 for MRSA-BSI and $6,914 for MSSA-BSI. Total

additional annual cost of nosocomial SA-BSI was $67,192,559. CONCLUSION: In view

of the burden of nosocomial SA-BSI, a national strategy for reducing nosocomial

SA-BSI is urgently needed in South Korea.