Impact of bloodstream infections caused by carbapenem-resistant Gram-negative pathogens on ICU costs, mortality and length of stay.
Acinetobacter baumannii
Hospital acquired infections
Klebsiella pneumoniae
Pseudomonas aeruginosa
clinical outcomes
financial impact
Journal
Infection prevention in practice
ISSN: 2590-0889
Titre abrégé: Infect Prev Pract
Pays: England
ID NLM: 101777928
Informations de publication
Date de publication:
Jun 2019
Jun 2019
Historique:
received:
01
07
2019
accepted:
15
08
2019
entrez:
9
8
2021
pubmed:
23
8
2019
medline:
23
8
2019
Statut:
epublish
Résumé
The aim of this study was to estimate the impact of bloodstream infections (BSIs) caused by carbapenem-resistant Gram-negative (CRGN) pathogens on hospital costs, mortality and length of stay (LOS). All patients hospitalized for ≥3 days in the Intensive Care Unit (ICU) of a tertiary-care general hospital from 1/1/2015 to 31/12/2017 were included in the study. A retrospective case-control study was performed in order to examine the difference in medical, pharmaceutical and operating costs, LOS and in-hospital mortality between patients with BSI caused by CRGN/without BSI (cases/controls, respectively). The statistical analysis was performed using the SPSS software (v23.0). A total of 419 patients (67.5% males, median age 60.0 years) were included in the analysis (142 cases/277 controls); 10 patients with non-CRGN BSIs were excluded. Overall mortality was 33.7% (49.3/25.6% in cases/controls). The median LOS and total cost were 30.0 vs. 12.0 days and 20 359.1 vs. 8,509.3 €, respectively, between patients with/without CRGN BSIs. After adjusting for baseline demographics, underlying disease severity and patients' specialties, CRGN BSIs remained a significant factor in mortality (odds ratio 2.9; 95% confidence interval 1.8-4.8; ICU patients with CRGN BSI are at increased risk for mortality and prolonged hospitalization and incur higher costs, imposing a heavy burden on healthcare system. Infection control strategies, considering also the cost-efficacy of interventions, are crucial in order to control the expansion of CRGN infections.
Sections du résumé
BACKGROUND
BACKGROUND
The aim of this study was to estimate the impact of bloodstream infections (BSIs) caused by carbapenem-resistant Gram-negative (CRGN) pathogens on hospital costs, mortality and length of stay (LOS).
METHODS
METHODS
All patients hospitalized for ≥3 days in the Intensive Care Unit (ICU) of a tertiary-care general hospital from 1/1/2015 to 31/12/2017 were included in the study. A retrospective case-control study was performed in order to examine the difference in medical, pharmaceutical and operating costs, LOS and in-hospital mortality between patients with BSI caused by CRGN/without BSI (cases/controls, respectively). The statistical analysis was performed using the SPSS software (v23.0).
RESULTS
RESULTS
A total of 419 patients (67.5% males, median age 60.0 years) were included in the analysis (142 cases/277 controls); 10 patients with non-CRGN BSIs were excluded. Overall mortality was 33.7% (49.3/25.6% in cases/controls). The median LOS and total cost were 30.0 vs. 12.0 days and 20 359.1 vs. 8,509.3 €, respectively, between patients with/without CRGN BSIs. After adjusting for baseline demographics, underlying disease severity and patients' specialties, CRGN BSIs remained a significant factor in mortality (odds ratio 2.9; 95% confidence interval 1.8-4.8;
CONCLUSIONS
CONCLUSIONS
ICU patients with CRGN BSI are at increased risk for mortality and prolonged hospitalization and incur higher costs, imposing a heavy burden on healthcare system. Infection control strategies, considering also the cost-efficacy of interventions, are crucial in order to control the expansion of CRGN infections.
Identifiants
pubmed: 34368681
doi: 10.1016/j.infpip.2019.100020
pii: S2590-0889(19)30020-4
pmc: PMC8335918
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100020Informations de copyright
© 2019 The Authors.
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