Evaluating the costs of Escherichia coli bloodstream infections: a population-based cohort study in a large metropolitan Canadian region.

IF 3.7 Q2 INFECTIOUS DISEASES JAC-Antimicrobial Resistance Pub Date : 2024-10-25 eCollection Date: 2024-10-01 DOI:10.1093/jacamr/dlae157
Teagan L King, Elissa Rennert-May, Ranjani Somayaji, Jenine Leal, Jason E Black, John M Conly, Daniel Gregson
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Abstract

Objectives: We evaluated the costs of susceptible and resistant Escherichia coli bloodstream infections (BSIs) in adults. Secondary outcomes were the impact of BSI on length of stay (LOS), readmissions and death.

Methods: We examined a population-based retrospective cohort of blood cultures from 2011 to 2018 in Calgary, Canada, linked to microcosting and gross costing data. Propensity score matching was completed, and costs were compared between no BSI and E. coli BSI over 90 days using linear regression.

Results: A total of 4581 BSIs in 89 673 adults experienced E. coli bacteraemia during the study period. The mean cost of an E. coli BSI at 90 days was $39 072 (SD: $95 747) in adults. Ceftriaxone-resistant (CRO-R) E. coli, resistant to fluoroquinolones (FQ) and trimethoprim/sulfamethoxazole, compared with susceptible E. coli BSI resulted in the greatest mean cost at $53 899 and the highest odds of readmission, increased LOS, and death.

Conclusions: E. coli BSI is associated with substantial costs. Total cost differences were highest in those with CRO-R E. coli with resistance to FQ and trimethoprim/sulfamethoxazole. Over the study period, bacteraemia secondary to these strains alone, added over $9 million to costs for healthcare in the Calgary Zone.

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评估大肠埃希菌血流感染的成本:在加拿大一个大都市地区开展的基于人群的队列研究。
目的:我们评估了成人易感性和耐药性大肠埃希菌血流感染(BSI)的成本。次要结果是 BSI 对住院时间(LOS)、再入院和死亡的影响:我们研究了加拿大卡尔加里市 2011 年至 2018 年期间基于人群的血培养回顾性队列,并将其与微观成本核算和总成本数据联系起来。我们完成了倾向得分匹配,并使用线性回归法比较了90天内无BSI和大肠杆菌BSI的成本:结果:在研究期间,89 673 名成人共经历了 4581 例 BSI,其中包括大肠杆菌菌血症。成人大肠杆菌 BSI 在 90 天内的平均费用为 39 072 美元(标度:95 747 美元)。与易感大肠杆菌 BSI 相比,对氟喹诺酮类(FQ)和三甲双氨/磺胺甲噁唑耐药的头孢曲松耐药(CRO-R)大肠杆菌导致的平均费用最高,为 53 899 美元,再次入院、延长生命周期和死亡的几率也最高:结论:大肠杆菌 BSI 与大量费用相关。对 FQ 和三甲双胍/磺胺甲噁唑耐药的 CRO-R 大肠杆菌感染者的总费用差异最大。在研究期间,仅继发于这些菌株的菌血症就使卡尔加里区的医疗成本增加了 900 多万美元。
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CiteScore
5.30
自引率
0.00%
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审稿时长
16 weeks
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