13,550 Staphylococcus aureus infections claimed 1,400 lives in New York City
while costing city hospitals $435 million to treat

Findings contained in PHRI-sponsored report prepared by The Lewin Group

NEW YORK -- June 12, 1997 -- The first study of the economic impact of infections caused by Staphylococcus aureus bacteria in the New York area shows that the 13,550 staph infections that occured in 1995 cost the city $435.5 million and claimed 1,400 lives.

NOTE: An article describing the study results in detail appeared in Emerging Infectious Diseases in 1999. Click here for EID Article.

"The average cost per infection of $32,110 is due to increased hospital stays, longer courses of treatment with more and more expensive antibiotics, a need to place patients with antibiotic resistant infections in isolation rooms, and other in-hospital procedures necessary to treat the infections," according to Robert J. Rubin, M.D., president and chief operating officer of The Lewin Group, who conducted the study for the Public Health Research Institute as part of the Bacterial Antibiotic Resistance Group/Infectious Disease Center (BARG/IDC) initiative.

Twenty-nine percent of the hospital cases were due to infections that were resistant to all antibiotics except for one -- vancomycin, Rubin reported. These cases accounted for one third of the total cost of hospital-based staph infections, and 48 percent of the mortality. Resistant infections are twice as likely to be fatal (17 percent versus 8 percent). If staph becomes resistant to vancomycin, already the last resort antibiotic in many cases, death rates would approach the pre-antibiotic era, at greater than 50 percent, and costs would increase significantly.

Recent reports indicate that the first clinical cases of vancomycin resistant staph have been documented.

"There is an irony of history here," says Alexander Tomasz, Ph.D., head of the Laboratory of Microbiology at The Rockefeller University. "The very first dramatic documentation of the life-saving power of the antibiotic penicillin involved a potentially fatal staphylococcal infection of a British police officer in 1941. Today, some 50 years later, we find ourselves confronted with the same bacterium, but now it is armed to the teeth with resistance genes against virtually all available antibacterial agents, including penicillin."

Staph bacteria are again the leading cause of hospital infections in the United States. They are responsible for 13 percent of the nation's two million hospital infections each year, and cause between 60,000 and 80,000 deaths.

The bacteria can live in membranes in the nose and throat, and can collect on clothing and medical equipment. Approximately 25 percent of the general population carries staph bacteria in their noses. The bacteria spreads by person-to-person physical contact. They can persist on environmental surfaces and survive and thrive on tubes inserted in the body and other prosthetic devices.

"The Lewin Study has broad implications for New York City, both in terms of the direct healthcare costs which it documents, and also in the potential impact of this problem on the city's economy," stated Lewis Weinstein, President of the Public Health Research Institute. "New York's prestigious hospital and healthcare sector is a major source of employment in the city. If antibiotic resistance problems become more prevalent here than elsewhere, the viability of this sector could be damaged".

"Ultimately, this problem could also impact other economic factors such as business location decisions and tourism," he added. "Our task is to combine efforts to limit the spread of antibiotic resistance so that these potentially serious consequences are avoided."

"Staph infections represent a significant cost to New York City in terms of medical resources and mortality," Rubin concluded. "Development and implementation of effective infection control programs could decrease these costs by reducing the incidence of staph infections, especially those that are antibiotic resistant."

"There is also a need for focused research to track the spread of drug resistant infections, to understand the reasons for such spread, and to work with private industry to develop new antibiotics to treat them," Weinstein added. "Research results can also be utilized to develop infection control measures and public policies to help contain the problem."

Weinstein also added the BARG/IDC initiative has a number of programs underway to accomplish these and related goals. This initiative is a collaborative program by the Public Health Research Institute, The Rockefeller University and the Bacterial Antibiotic Resistance Group.

The Lewin Group is an internationally recognized healthcare policy and management consulting firm headquartered near Washington, DC, with offices throughout the United States and Europe. The firm specializes in helping public and private sector clients develop solutions to the challenges of the changing healthcare marketplace.

The study was funded through grants from Pfizer, Inc., the Horace W. Goldsmith Foundation, the New York Community Trust, the Texaco Foundation, the United Hospital Fund of New York City and the U.S. Centers for Disease Control & Prevention (CDC).