Attributable burden in patients with carbapenem-nonsusceptible gram-negative respiratory infections

Abstract

ObjectiveWe aimed to describe the clinical and economic burden attributable to carbapenem-nonsusceptible (C-NS) respiratory infections. MethodsThis retrospective matched cohort study assessed clinical and economic outcomes of adult patients (aged �18 years) who were admitted to one of 78 acute care hospitals in the United States with nonduplicate C-NS and carbapenem-susceptible (C-S) isolates from a respiratory source. A subset analysis of patients with principal diagnosis codes denoting bacterial pneumonia or other diagnoses was also conducted. Isolates were classified as communityor hospital-onset based on collection time. A generalized linear mixed model method was used to estimate the attributable burden for mortality, 30-day readmission, length of stay (LOS), cost, and net gain/loss (payment minus cost) using propensity score-matched C-NS versus C-S cohorts.

The economic burden of antibiotic resistance: A systematic review and meta-analysis

“…As reported in Table 2 , 20 out of the 29 studies (69%) were conducted in high income economies (HIE) [ 47 – 65 ] and rest (n = 9, 31%) were conducted in upper-middle income economies (UMIE) [ 66 – 74 ], but there were no studies from low-income economies (LIE). The countries which produced the highest number of studies were the USA (n = 10, 34.5%) [ 50 , 51 , 53 – 55 , 58 , 60 , 65 , 75 , 77 ], followed by China (n = 7, 24.1%) [ 66 , 67 , 69 – 73 ] and Japan (n = 3, 10.3%) [ 47 – 49 ].…”

“…Majority of the included studies (n = 18, 62.1%) were conducted in multiple centres [ 47 – 50 , 51 , 53 – 57 , 65 , 66 , 69 , 73 – 76 ], 48.3% studies (n = 14) were about gram negative bacteria [ 50 , 51 , 53 , 56 – 60 , 62 , 68 , 70 – 72 , 75 ], 27.6% (n = 8) were about gram positive bacteria [ 47 – 49 , 55 , 63 , 67 , 69 , 76 ] and rest (n = 7, 24.1%) were a mix of both [ 54 , 61 , 64 – 66 , 73 , 74 ]. Out of the total included studies, 27.6% (n = 8) focused on hospital acquired infections (HAI) [ 50 , 53 , 59 – 61 , 63 , 66 , 72 ], 10.3% (n = 3) on community acquired infections (CAI) [ 47 , 51 , 56 ], and 24.1% (n = 7) included both HAI and CAI [ 49 , 57 , 64 , 65 , 67 , 74 , 75 ]. The remainder of studies did not clearly distinguish type of infection.…”

Imipenem/Cilastatin/Relebactam: A Review in Gram-Negative Bacterial Infections

“…The clinical and economic burden of treating patients with carbapenem-resistant gram-negative infections is substantial [ 3 , 5 , 59 , 60 ]. Subsequently, optimizing antibacterial therapy through antimicrobial stewardship is important to maximize clinical outcomes while reducing the economic burden and minimizing the unintended consequences of antibacterial use (e.g.…”

“…Carbapenems are broad-spectrum β‐lactam antibacterial agents that play a critical role in the management of complicated and serious infections caused by such pathogens, especially against strains producing extended-spectrum β-lactamases (ESBLs) [ 2 ]. However, the growing emergence and spread of carbapenem-resistant pathogens worldwide exacerbates the clinical challenge of treating these infections [ 3 – 5 ]. Polymyxins (i.e.…”

Análise de colonização bacteriana em copos umidificadores utilizados na oxigenoterapia em pacientes internados em um Hospital Universitário

“…A resistência bacteriana é compreendida como um problema de saúde global a ser sanado em decorrências do impacto nos custos hospitalares por aumento do período de internação e insumos terapêuticos, além da piora do prognóstico clínico dos pacientes. O conhecimento da incidência e do perfil dos patógenos relacionados as infecções multirresistentes permite o estabelecimento de práticas terapêuticas assertivas, influindo na redução da suscetibilidade de microrganismos multirresistentes (Tabak et al, 2020).…”