# The Hospitalization Cost of Pediatric Staphylococcus aureus Bacteremia

## TL;DR

This study calculates the hospitalization costs of Staphylococcus aureus infections in children in Australia, showing a significant economic burden.

## Contribution

The study provides the first detailed economic analysis of pediatric Staphylococcus aureus bacteremia hospitalization costs in Australia.

## Key findings

- The mean hospitalization cost per child with community-onset SAB was A$53,037.
- The annual total cost for community-onset SAB at Perth Children’s Hospital was A$1,485,058.
- Hospital-onset SAB costs were significantly higher than community-onset SAB costs.

## Abstract

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.

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.

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.

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.