Abstract
Background and objectivesIncidence rates of healthcare-associated infections (HAIs) depend upon infection control policy and practices, and the effectiveness of the implementation of antibiotic stewardship. Amongst intensive care unit (ICU) patients with HAIs, a substantial number of pathogens were reported to be multidrug-resistant bacteria (MDRB). However, impacts of ICU HAIs due to MDRB (MDRB-HAIs) remain understudied. Our study aimed to evaluate the negative impacts of MRDB-HAIs versus HAIs due to non-MDRB (non-MRDB-HAIs).MethodsAmong 60,317 adult patients admitted at ICUs of a 2680-bed medical centre in Taiwan between January 2010 and December 2017, 279 pairs of propensity-score matched MRDB-HAI and non-MRDB-HAI were analyzed.Principal findingsBetween the MDRB-HAI group and the non-MDRB-HAI group, significant differences were found in overall hospital costs, costs of medical and nursing services, medication, and rooms/beds, and in ICU length-of-stay (LOS). As compared with the non-MDRB-HAI group, the mean of the overall hospital costs of patients in the MDRB-HAI group was increased by 26%; for categorized expenditures, the mean of costs of medical and nursing services of patients in the MDRB-HAI group was increased by 8%, of medication by 26.9%, of rooms/beds by 10.3%. The mean ICU LOS in the MDRB-HAI group was increased by 13%. Mortality rates in both groups did not significantly differ.ConclusionsThese data clearly demonstrate more negative impacts of MDRB-HAIs in ICUs. The quantified financial burdens will be helpful for hospital/government policymakers in allocating resources to mitigate MDRB-HAIs in ICUs; in case of need for clarification/verification of the medico-economic burdens of MDRB-HAIs in different healthcare systems, this study provides a model to facilitate the evaluations.
Highlights
The vulnerabilities of patients admitted to intensive care units (ICUs) make them subject to high risk for healthcare-associated infections (HAIs), and therapeutically-indicated invasive procedures/devices add to the problem [1, 2]
The quantified financial burdens will be helpful for hospital/government policymakers in allocating resources to mitigate multidrug-resistant bacteria (MDRB)-HAIs in ICUs; in case of need for clarification/verification of the medico-economic burdens of MDRB-HAIs in different healthcare systems, this study provides a model to facilitate the evaluations
Patients, hospital setting and antibiotic stewardship. This is retrospective case-control study comparing the differences in financial burdens, hospital/ICU LOS and mortality in adult patients with MRDB-HAIs and those with nonMDRB-HAIs admitted at ICUs of Kaohsiung Chang Gung Memorial Hospital (KSCGMH), a 2680-bed facility serving as a primary care and tertiary referral medical centre in southern Taiwan
Summary
The vulnerabilities of patients admitted to intensive care units (ICUs) make them subject to high risk for healthcare-associated infections (HAIs), and therapeutically-indicated invasive procedures/devices add to the problem [1, 2]. ICU-associated HAIs contribute to increased mortality, financial expenditures, and ICU length-of-stay (LOS) [3] When it comes to etiologies, HAIs acquired from ICU setting are subject to remarkably high risk of being caused by multidrug-resistant bacteria (MDRB) [4, 5]. Incidence rates of HAIs depend on infection control policy and practices [6,7,8,9,10,11,12], and the effectiveness of the implementation of antibiotic stewardship [4, 8, 13,14,15,16]. Incidence rates of healthcare-associated infections (HAIs) depend upon infection control policy and practices, and the effectiveness of the implementation of antibiotic stewardship. Our study aimed to evaluate the negative impacts of MRDB-HAIs versus HAIs due to non-MDRB (non-MRDB-HAIs)
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