PMU82 EFFECT OF CARBAPENEM RESISTANCE ON TOTAL HOSPITALIZATION COSTS AMONG INPATIENTS WITH PSEUDOMONAS AERUGINOSA: A MULTICENTER STUDY IN CHINA

Abstract

Pseudomonas aeruginosa is one of the most common hospital-acquired gram-negative bacteria, and carbapenems are often first choice to treat resistant infection with gram-negative bacteria. During 2005 and 2014 in China, the resistance level was around 30% for carbapenem resistant P. aeruginosa (CRPA), which is associated with higher health resource utilization. This study aimed to compare differences in the hospitalization costs between inpatients with CRPA and carbapenem-susceptible P. aeruginosa (CSPA) in four hospitals in China. This is a retrospective and multicenter study. All inpatients who detected clinical culture positive for P. aeruginosa between 2013 and 2015 were included. We selected inpatients with the first episode of P. aeruginosa and classified them into CRPA or CSPA group based on antibiotic susceptibility testing. Univariate and a generalized linear model were conducted to explore the factors associated with total hospitalization cost (THC). A total of 6483 inpatients with P. aeruginosa were included (2317 CRPA; 4166 CSPA). The mean differences in THC, medication cost, antibiotic cost, diagnostic cost, treatment cost, and material cost were ¥33231, ¥16984, ¥2178, ¥2916, ¥7295, and ¥2836, respectively, between CRPA and CSPA group. Compared with CSPA cases, CRPA cases were associated with longer length of stay before first culturing (9.32 vs 6.19, <0.000), longer intensive care unit stays (1.92 vs 1.39, <0.000), and higher mortality rate (6.30% vs 3.19%, <0.000). In the generalized linear model, there remained a significantly independent association between carbapenem resistance and THC. Our study highlights the heavy financial burden imposed by P. aeruginosa and carbapenem resistance on the Chinese healthcare system, and provides information that should take increased efforts to decrease the development of CRPA and their economic burden.