Infections with Methicillin-Resistant Staphylococcus Aureus (MRSA) in U.S. Hospitals,
                                                                            1993–2005 [Excerpt]
Anne Elixhauser, Ph.D. and Claudia Steiner, M.D., M.P.H.                                                                                                  July 2007

This information is based on Healthcare Cost and Utilization Project (HCUP). August 2006. U.S. Agency for Healthcare Research and
Quality documentation from 38 states.      HCUP is based on data from community hospitals, defined as short-term, non-Federal,
general and other hospitals, excluding hospital units of other institutions (e.g., prisons). HCUP data include OB-GYN, ENT,
orthopedic, cancer, pediatric, public, and academic medical hospitals. They exclude long-term care, rehabilitation, psychiatric, and
alcoholism and chemical dependency hospitals, but these types of discharges are included if they are from community
hospitals.                                                                                  

In 2005, there were about 368,600 hospital stays for infections with MRSA (an antibiotic-resistant bacterium). Hospital stays for these
infections more than tripled after 2000 and increased nearly tenfold after 1995. The increase from 2004 to 2005 was 30 percent.

The highest rate of MRSA hospitalization was among the elderly—360.8 MRSA stays per 100,000. This was more than three times
higher than for any other age group: 114.7 stays for infants, 19.2 for 1- to 17-year-olds, 58.1 for 18- to 44-year-olds, and 111.5 for 45-
to 64-year-olds per 100,000 discharges  

[On average about 1 in 20 (5%) died. The figures do not break out necrotizing fasciitis infections where the death rates are from
20 to 73%].

Figure 1. Hospital stays with methicillin–resistant Staphylococcus aureus (MRSA) infections, 1993–2005

                                                                          Total number of discharges






Figure 2. Rates of hospitalization with MRSA infection per 100,000 population, by region and gender, 2004
                                                                    Discharges with MRSA infections






Table 2. Most common principal diagnoses for hospital stays with MRSA infection,* 2004






















*MRSA can only appear as a secondary diagnosis.
Source: AHRQ, Center for Delivery, Organization, and Markets, Healthcare Cost and Utilization Project, Nationwide Inpatient Sample,
2004.





Table 3. Most common all-listed procedures for hospital stays with MRSA infection,* 2004
Percent of stays























*MRSA can only appear as a secondary diagnosis.
Source: AHRQ, Center for Delivery, Organization, and Markets, Healthcare Cost and Utilization Project, Nationwide Inpatient Sample,
2004.


HCUP is a family of powerful health care databases, software tools, and products for advancing research. Sponsored by the Agency
for Healthcare Research and Quality (AHRQ), HCUP includes the largest all-
payer encounter-level collection of longitudinal health care data (inpatient, ambulatory surgery, and
emergency department) in the United States, beginning in 1988. HCUP is a Federal-State-Industry Partnership that brings together
the data collection efforts of many organizations—such as State data organizations, hospital associations, private data organizations,
and the Federal government—to create a national information resource.

For more information about HCUP, visit http://www.hcup-us.ahrq.gov/.

HCUP would not be possible without the contributions of the following data collection Partners from across the United States:


Arizona Department of Health Services
Arkansas Department of Health & Human Services
California Office of Statewide Health Planning & Development
Colorado Health & Hospital Association
Connecticut Integrated Health Information (Chime, Inc.)
Florida Agency for Health Care Administration
Georgia GHA: An Association of Hospitals & Health Systems
Hawaii Health Information Corporation
Illinois Health Care Cost Containment Council and Department of Public Health
Indiana Hospital&Health Association
Iowa Hospital Association
Kansas Hospital Association
Kentucky Cabinet for Health and Family Services
Maryland Health Services Cost Review Commission
Massachusetts Division of Health Care Finance and Policy
Michigan Health & Hospital Association
Minnesota Hospital Association
Missouri Hospital Industry Data Institute
Nebraska Hospital Association
Nevada Division of Health Care Financing and Policy, Department of Human Resources
New Hampshire Department of Health & Human Services
New Jersey Department of Health & Senior Services
New York State Department of Health
North Carolina Department of Health and Human Services
Ohio Hospital Association
Oklahoma Health Care Information Center for Health Statistics
Oregon Office for Oregon Health Policy and Research and Oregon Association of Hospitals and Health Systems
Rhode Island Department of Health
South Carolina State Budget & Control Board
South Dakota Association of Healthcare Organizations
Tennessee Hospital Association
Texas Department of State Health Services
Utah Department of Health
Vermont Association of Hospitals and Health Systems
Virginia Health Information
Washington State Department of Health
West Virginia Health Care Authority
Wisconsin Department of Health & Family Services

http://www.hcup-us.ahrq.gov/reports/statbriefs/sb35.pdf
1
 Skin and subcutaneous tissue infections
 54,600
 18.9
 1.2
2
 Pneumonia
 26,000
 9.0
 3.1
3
 Complication of device, implant or graft
 23,500
 8.1
 1.5
4
 Complication of surgical procedure or medical care
 22,200
 7.7
 1.1
5
 Septicemia
 21,200
 7.3
 1.1
6
 Infective arthritis and osteoarthritis
 10,400
 3.6
 0.2
7
 Diabetes mellitus with complications
 9,600
 3.3
 1.3
8
 Urinary tract infections
 8,700
 3.0
 1.3
9
 Respiratory failure
 7,100
 2.5
 0.7
10
 Chronic ulcer of skin
 6,800
 2.3
 0.2



Rank


                     Principal diagnosis
 Number of
stays with
MRSA
infection
MRSA
 No MRSA
Percent of stays with this
principal diagnosis among
stays with
1
 Incision and drainage, skin and subcutaneous tissue
 33,300
 6.7
 0.3
2
 Debridement of wound, infection, or burn
 32,000
 6.5
 0.7
3
 Blood transfusion
 31,600
 6.4
 4.6
4
 Respiratory intubation and mechanical ventilation
 22,400
 4.5
 2.5
5
 Hemodialysis
 16,400
 3.3
 1.4
6
 Echocardiogram
 10,400
 2.1
 1.4
7
 Enteral and parenteral nutrition
 10,300
 2.1
 1.0
8
 Upper gastrointestinal endoscopy and biopsy
 9,400
 1.9
 2.6
9
 Diagnostic bronchoscopy
 8,800
 1.8
 0.7
10
 Partial excision bone
 7,000
 1.4
 0.4




Rank



All-listed procedures
Number of
stays with
MRSA
infection
MRSA
 No MRSA
Percent of stays with this
procedure among stays with
1993
1,900
 1994
17,600
 1995
38,100
 1996
50,300
 1997
69,800
 1998
89,400
 1999
100,600
 2000
128,500
 2001
175,000
 2002
207,900
 2003
240,300
 2004
289,100
 2005
368,300
Northeast
 Midwest
 South
 West
   Male
 Female
88.9
 88.8
 113.2
 99.5
   106.6
 92.2