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The Hospitalization Cost of Pediatric Staphylococcus aureus Bacteremia
Keerthi Anpalagan1,2, Christopher C Blyth1,2,3,4, Jonathan R Carapetis1,2,3
1School of Medicine, University of Western Australia, Perth, WA, Australia.
Insights
Childhood Staphylococcus aureus bacteraemia (SAB) hospitalizations incur substantial costs, averaging over A$53,000 per case. This economic burden highlights the need for continued prevention and treatment strategies targeting S. aureus in children.
Area of Science:
- Paediatric Infectious Diseases
- Health Economics
- Clinical Microbiology
Background:
- Staphylococcus aureus bacteraemia (SAB) is a leading cause of paediatric sepsis and intensive care unit admissions.
- Limited data exists on the economic impact of childhood SAB hospitalizations globally.
- This study addresses the knowledge gap by investigating the cost of SAB hospitalizations in Australian children.
Purpose of the Study:
- To determine the mean hospitalization cost for pediatric patients with Staphylococcus aureus bacteraemia (SAB) in Australia.
- To analyze cost variations based on community-onset versus hospital-onset SAB.
- To provide the first detailed economic evaluation of childhood SAB hospitalizations.
Main Methods:
- Economic analysis of hospitalization costs for children (<18 years) with SAB at Perth Children's Hospital (2017-2018).
- Data sourced from the Invasive S. aureus Infections and Hospitalisations (ISAIAH) cohort.
- Mean hospitalization cost calculated using bootstrapping for 95% confidence intervals.
Main Results:
- The mean hospitalization cost for community-onset SAB was A$53,037 per patient.
- Total annual cost for community-onset SAB at PCH was estimated at A$1,485,058.
- Hospital-onset SAB was significantly more costly than community-onset; antibiotic susceptibility did not impact community-onset costs.
Conclusions:
- This study presents the first in-depth economic analysis of childhood SAB hospitalizations.
- The economic burden of childhood SAB is substantial, irrespective of antibiotic susceptibility.
- Prevention and treatment strategies targeting Staphylococcus aureus remain crucial.
Background:
Staphylococcus aureus bacteremia (SAB) is the most common cause of childhood sepsis contributing to pediatric intensive care unit admission. The cost of adult SAB hospitalization is well described globally, but limited costing information is available for children. To bridge this knowledge gap, we investigated the cost of hospitalization in children with SAB in Australia.
Methods:
An economic analysis of hospitalization costs involving children aged ≤18 years with SAB admitted to Perth Children's Hospital (PCH) between January 2017 and December 2018 was completed. Children were identified from the Invasive Staphylococcus aureus Infections and Hospitalisations (ISAIAH) cohort, a prospective multicenter study of pediatric SAB in Australia and New Zealand. The primary measure was mean hospitalization cost of community-onset SAB, overall and stratified by key variables, with 95% CIs calculated by bootstrapping.
Results:
There were 61 patients with SAB admitted to PCH. Fifty-six patients had community-onset SAB. The mean hospitalization cost per patient with community-onset SAB was A$53 037 [95% CI $44 623-$61 452]. The annual total cost was A$1 485 058. Hospital-onset SAB costs were significantly higher than community-onset SAB costs, and there was no difference in hospitalization costs by antibiotic susceptibility profile for community-onset SAB. The total cost of pediatric hospitalization for community-onset SAB within the ISAIAH cohort was estimated to be over A$9 million.
Conclusion:
This study provides the first in-depth analysis of the cost of hospitalization for SAB in children. This study suggests that the economic burden of SAB in children is substantial, and prevention and treatment strategies should remain focused on S. aureus as a whole.
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