PCV59 Economic Burden Associated with the Management of Mycobacterium Quimaera Endocarditis from the Perspective of a Spanish Hospital

Abstract

Mycobacterium Chimaera (M.Chimaera) is a highly resistant microorganism responsible for the development of severe infections in patients undergoing cardiothoracic surgeries with extracorporeal circulation. Infections become clinically apparent after a time lag of months to years and lead to significant mortality and morbidity. Recommended treatment includes a combination of multiple antimicrobial drugs and the removal of foreign material. The aim of this study was to determine the cost associated with the management of a M.Chimaera endocarditis from a Spanish hospital perspective. A cost analysis was developed based on previously published results on health resource use (HRU) of the management of a prosthetic infective endocarditis. Unit costs were applied to estimates of HRU comprising diagnostic tests, hospital length of stay and pharmacological treatment. Costs were obtained from different Spanish sources and expressed in €2020. Deterministic sensitivity analysis was performed to assess the robustness of the base case results. The mean cost of the management of a M. Chimaera infection was €93,470.68 (€84,123.61- €102,817.75). Inpatient length of stay (121 days) represented the major cost driver (€77,936.79; 83.4%) followed by the pharmacological treatment (€5,058.99; 5.4%) and the aortic valve replacement surgery (€4,59.49; 4.9%), respectively. M. Chimaera associated infections represent a relevant economic burden for the hospitals. Current prevention strategies such as heater-cooler units disinfection protocols, and equipment removal from the operating room have clinically demonstrated to be insufficient and costly. Innovative machines such us non-toxic glycol based HCUs should be taken into consideration due to its proven long-term bactericidal properties in order to avoid potential infections in patients undergoing chest surgeries.