Presentation (CTI)

OBJECTIVES: Hospital-onset methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections (BSI) pose a significant clinical and economic burden. Recent evidence on healthcare resource utilization (HCRU) and costs for these infections is limited. This study evaluated real-world HCRU, costs, and outcomes associated with hospital-onset MRSA BSI in U.S. hospitals.
METHODS: A retrospective cohort study was conducted using the Premier Healthcare Database. Hospitalizations of adult patients (≥18 years) with microbiologically confirmed hospital-onset MRSA BSI who were discharged between January 1, 2023, and June 30, 2025, were included. Outcomes assessed were HCRU, including length of stay (LOS), ICU utilization, in-hospital mortality, and 180-day readmissions, and costs for index hospitalization and follow-up.
RESULTS: A total of 2,522 hospitalizations met inclusion criteria. Median LOS was 11 days (IQR: 7-23), and median index hospitalization cost was $32,980 (IQR: $18,321-$69,792). ICU admission occurred in 46.6% of patients, with a median ICU LOS of 5 days (IQR: 2-12) and median ICU cost of $31,561 (IQR: $13,884-$83,491). In-hospital mortality was 22.2%. Of those surviving the index hospitalization (n=2,210), within 180 days of discharge, 57.6% (n=1,272) had all-cause readmissions, and 42.5% (n=940) had BSI-related readmissions. Median time to first readmission was 32 days (IQR: 13-66). The cumulative cost for all-cause readmissions during the 180-day follow-up was $41,291 (IQR: $19,709-$81,311) among those with any readmission in that period.
CONCLUSIONS: Hospital-onset MRSA BSI is associated with substantial resource utilization, high mortality, and significant economic burden. Frequent and costly readmissions highlight the need for targeted strategies, including better infection prevention and optimized discharge planning, to reduce readmission risks and improve patient outcomes.