Abstract

BACKGROUND: Carbapenem-producing Enterobacterales are an expanding group of Gram-negative bacteria that are resistant to carbapenems and cause over 9,000 cases of hospital-associated infections in the US. Efforts to quantify the economic and societal burden to healthcare are important to inform resource planning to implement infection control programmes. AIM: We estimated the healthcare costs during an outbreak of carbapenemase-producing Escherichia coli OXA-181 in Australia. We aimed to understand the economic burden to hospitals of patients who are asymptomatically colonized with high-risk bacteria. METHODS: Hospital admissions data and associated costs were obtained from the State Health Department. Colonized patients were matched to non-colonized patients on age, sex, admission ward and diagnostic category. Mean healthcare costs and length of stay were examined using generalized linear models and accounted for time-dependent bias, patient age, and ward location. FINDINGS: On average, colonized patients had six times higher mean costs (AU$155 784; 95% CI: AU$77 892 - AU$285 604)) than non-colonized patients (AU$25 964). Mean costs for those aged 75-79 years were 50% lower (p=0.02) compared to the youngest subgroup, 35-39 years old. The mean extended length of stay was 12 days (95% CI: 3-21) for colonized patients. Nursing care was the main driver of overall costs for colonized (44%) and non-colonized (39%) patients. CONCLUSION: Patients colonized with carbapenem-producing Enterobacterales during an official hospital outbreak incurred higher costs than non-colonized patients. Although infected patients incur substantial economic burden to hospitals, the costs incurred by colonized patients is also high.

Authors	Rodriguez-Acevedo, Astrid J; Lee, Xing J; Elliot, Thomas M; Gordon, Louisa G
Journal	The Journal of hospital infection
Pages	146-153
Volume	105
Date	1/03/2020
Grant ID
Funding Body	Queensland Genomics, Queensland Health, Queensland Government
URL	http://www.ncbi.nlm.nih.gov/pubmed/?term=10.1016/j.jhin.2020.03.009