Our results confirm that hospital acquired infections/bacteria have higher rates of resistance when compared to community acquired; these rates increase with age, immunosuppression and are inversely proportional with COPD. Therefore, physicians should be aware of patients' comorbidities to properly guide initial therapy.

Background Our aim was to examine whether the length of stay, hospital charges and in-hospital mortality attributable to healthcare- and community-associated infections due to antimicrobial-resistant bacteria were higher compared with those due to susceptible bacteria in the Lebanese healthcare settings using different methodology of analysis from the payer perspective . Methods We performed a multi-centre prospective cohort study in ten hospitals across Lebanon. The sample size consisted of 1289 patients with documented healthcare-associated infection (HAI) or community-associated infection (CAI). We conducted three separate analysis to adjust for confounders and time-dependent bias: (1) Post-HAIs in which we included the excess LOS and hospital charges incurred after infection and (2) Matched cohort, in which we matched the patients based on propensity score estimates (3) The conventional method, in which we considered the entire hospital stay and allocated charges attributable to CAI. The linear regression models accounted for multiple confounders. Results HAIs and CAIs with resistant versus susceptible bacteria were associated with a significant excess length of hospital stay (2.69 days [95% CI,1.5–3.9]; p < 0.001) and (2.2 days [95% CI,1.2–3.3]; p < 0.001) and resulted in additional hospital charges ($1807 [95% CI, 1046–2569]; p < 0.001) and ($889 [95% CI, 378–1400]; p = 0.001) respectively. Compared with the post-HAIs analysis, the matched cohort method showed a reduction by 26 and 13% in hospital charges and LOS estimates respectively. Infections with resistant bacteria did not decrease the time to in-hospital mortality, for both healthcare- or community-associated infections. Resistant cases in the post-HAIs analysis showed a significantly higher risk of in-hospital mortality (odds ratio, 0.517 [95% CI, 0.327–0.820]; p = 0.05). Conclusion This is the first nationwide study that quantifies the healthcare costs of antimicrobial resistance in Lebanon. For cases with HAIs, matched cohort analysis showed more conservative estimates compared with post-HAIs method. The differences in estimates highlight the need for a unified methodology to estimate the burden of antimicrobial resistance in order to accurately advise health policy makers and prioritize resources expenditure.

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Background: Infection Prevention and Control (IPC) measures are related to medical practices that prevent or minimize spreading of infectious diseases. The purpose of this study was to evaluate the effect of IPC measures on the length of hospital stay (LOS) of patients in infectious diseases service at Lebanese hospitals. Methods: This was a prospective cohort study in two Lebanese hospitals between January 2017 and July 2017. Hospital 1 was a governmental university hospital located in Beirut with a total number of 544 beds, with Composite Index of Activities for the Control of Nosocomial Infections-2 (CIACNI-2) and Composite Indicator of Control of Multi-Resistant Bacteria (CIC-MRB) scores of 76/100 and 69/100, respectively. Hospital 2 was a non-university private hospital located in Mount Lebanon with a total number of 110 beds, CIACNI-2 and CIC-MRB scores of 95/100 and 70/100, respectively. Adult patients of both genders aged over 18 years, admitted to the intensive care, internal medicine or surgical wards, with positive bacteria cultures and treated with antibiotics were eligible to be enrolled in the study. The primary outcome was to assess the effect of IPC measures of each hospital on the total LOS. Bivariate and multivariable analyses were used to identify the statistical associations. Results: A total of 369 patients were enrolled in the study. Private hospital had higher scores of IPC measures. Patients at the hospital with lower IPC measures had an additional LOS of 2 ± 2.73 days when compared to the hospital with higher IPC measures (p = 0.106). Multi linear regression showed that the hospital with higher IPC measures was associated with significant shorter LOS (p < 0.001). Conclusion: Applying high standards of IPC measures can decrease the total length of hospital stay in Lebanese hospitals.