BACKGROUND Information on outcomes of methicillin-susceptible and -resistant Staphylococcus aureus (MSSA and MRSA, respectively) bacteremia, particularly readmission, is scarce and requires further research to inform optimal patient care. METHODS We performed a retrospective analysis using the 2014 Nationwide Readmissions Database, capturing 49.3% of US hospitalizations. We identified MSSA and MRSA bacteremia using International Classification of Diseases, Ninth Revision, Clinical Modification among patients aged ≥18 years. Thirty-day readmission, mortality, length of stay, and costs were assessed using Cox proportional hazards regression, logistic regression, Poisson regression, and generalized linear model with gamma distribution and log link, respectively. RESULTS Of 92 089 (standard error [SE], 1905) patients with S. aureus bacteremia, 48.5% (SE, 0.4%) had MRSA bacteremia. Thirty-day readmission rate was 22% (SE, 0.3) overall with no difference between MRSA and MSSA, but MRSA bacteremia had more readmission for bacteremia recurrence (hazard ratio, 1.17 [95% confidence interval {CI}, 1.02-1.34]), higher in-hospital mortality (odds ratio, 1.15 [95% CI, 1.07-1.23]), and longer hospitalization (incidence rate ratio, 1.09 [95% CI, 1.06-1.11]). Readmission with bacteremia recurrence was particularly more common among patients with endocarditis, immunocompromising comorbidities, and drug abuse. The cost of readmission was $12 425 (SE, $174) per case overall, and $19 186 (SE, $623) in those with bacteremia recurrence. CONCLUSIONS Thirty-day readmission after S. aureus bacteremia is common and costly. MRSA bacteremia is associated with readmission for bacteremia recurrence, increased mortality, and longer hospitalization. Efforts should continue to optimize patient care, particularly for those with risk factors, to decrease readmission and associated morbidity and mortality in patients with S. aureus bacteremia.

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耐甲氧西林和耐甲氧西林的金黄色葡萄球菌细菌血症：在美国的30天再入院率，住院死亡率，住院时间和费用的全国性估计。

背景技术关于甲氧西林敏感和耐药金黄色葡萄球菌（分别为MSSA和MRSA）菌血症，特别是再入院的结果的信息很少，需要进一步研究以提供最佳的患者护理。方法我们使用2014年全国再入院数据库进行了回顾性分析，涵盖了49.3％的美国住院患者。我们使用国际疾病分类，第九次修订版，≥18岁的患者的临床改良方法鉴定了MSSA和MRSA菌血症。使用Cox比例风险回归，对数回归，泊松回归以及具有伽玛分布和对数链接的广义线性模型分别评估了30天的再入院率，死亡率，住院时间和费用。结果92 089名患者（标准误[SE]，1905年）患有金黄色葡萄球菌菌血症，48名。5％（SE，0.4％）患有MRSA菌血症。三十天的再入院率为22％（SE，0.3），MRSA和MSSA之间没有差异，但是MRSA菌血症的再入院率更高（细菌比率，1.17 [95％置信区间{CI}，1.02-1.34]） ，更高的院内死亡率（赔率，1.15 [95％CI，1.07-1.23]）和更长的住院时间（发生率，1.09 [95％CI，1.06-1.11]）。在患有心内膜炎，免疫功能低下的合并症和药物滥用的患者中，菌血症复发的再入院尤为常见。每个病例的再入院总费用为12 425美元（SE，174美元），而细菌菌血症复发患者的再入院费用为19 186美元（SE，623美元）。结论金黄色葡萄球菌菌血症后的30天再入院是常见且昂贵的。MRSA菌血症与再入菌血症相关，死亡率增加，住院时间更长。应继续努力优化患者的护理，尤其是对那些有危险因素的患者，以减少金黄色葡萄球菌菌血症患者的再入院率以及相关的发病率和死亡率。