Burden of Clostridium Difficile and Methicillin-Resistant Staphylococcus Aureus: An Assessment of Nationwide Inpatient Sample
Robert M. Avina, Karina E. Corral,
Benjamin J Becerra and Monideepa B
Correspondence Address :
Monideepa B. Becerra
Department of Health Science and Human Ecology
California State University
San Bernardino, 5500
San Bernardino, CA 92407, USA
Received on: September 27, 2018, Accepted on: October 01, 2018, Published on: October 08, 2018
Citation: Monideepa B. Becerra, Robert M. Avina, Karina E. Corral, Benjamin J. Becerra (2018). Burden of Clostridium Difficile and Methicillin-Resistant
Staphylococcus Aureus: An Assessment of Nationwide Inpatient Sample
Copyright: 2018 Monideepa B. Becerra, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which
permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: Human immunodeficiency virus (HIV) infection is an epidemic that affects over 1.2 million people in the U.S. Given the lowered immunity of HIV patients, often co-morbidities may posit a public health threat, of particular concern is the coinfection of Clostridium di icile infection (CDI) and methicillin-resistant staphylococcus aureus (MRSA). Despite the empirical evidence highlighting the burden of CDI and MRSA co-infections among HIV patients, there remains a gap in the literature on how such coinfections impact patient and hospital outcomes. As such, the purpose of this study was to utilize the largest national inpatient database in the U.S. to assess patient and healthcare burden of CDI and MRSA among HIV patients.
Methods: This study was a retrospective analysis of the Nationwide Inpatient Sample. The sample included primary HIV discharges, identified using the Clinical Classifications Software Codes while ICD-9-CM codes were used to identify CDI and MRSA. In-hospital mortality was identified from records for reason of discharge as died during hospitalization. Length of stay was provided by NIS and total charges were inflationadjusted using the GDP deflator. Survey weights were used for all analyses.
Results: The prevalence of CDI and MRSA were 2.88% and 3.12%, respectively among HIV discharges. Results demonstrate that HIV patients with CDI and MRSA had a 102% and 43% higher LOS compared with no CDI, respectively. Presence of CDI and MRSA increased in-hospital mortality by 73% and 33%, respectively. Likewise, CDI increased in total charges by 77.6% and MRSA increased in total charges by 52%.
Conclusion: This is the first study to identify the burden of CDI and MRSA infection among HIV patients. Results demonstrate higher healthcare cost and negative patient outcomes resulting from such co-infections. Increased hospital infection control stewardship for such patients is critical in order to improve health equity among HIV patients.
Keywords: HIV, Hospital infections, Health disparities, Healthcare cost