Burden of <i>Clostridium difficile</i> Infections in French Hospitals in 2014 From the National Health Insurance Perspective

Leblanc, Soline; Blein, C.; Andremont, Antoine; Bandinelli, Pierre-Alain; Galvain, Thibaut

doi:10.1017/ice.2017.114

Cited by 10 publications

(5 citation statements)

References 25 publications

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“…Subsequent studies indicate that C. difficile infections are in 18th place, among the main causes of mortality in the >65 years age group [ 9 ]. At the same time, the costs of treatment of a single patient with a CDI infection amount from USD 2000 to 72,000 [ 10 , 11 , 12 , 13 , 14 ]. Another available publication on the economics of CDI infections in the US has indicated that this infection increases hospitalisation-related costs by more than half, and lengthens a patient’s hospital stay by an average of 3.6 days.…”

Section: Discussionmentioning

confidence: 99%

Costs Associated with the Treatment of Clostridioides Difficile Infections

Sierocka

Kiersnowska

Lemiech-Mirowska

et al. 2021

IJERPH

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Background: Clostridioides difficile, as the main cause of infectious diarrhoea in hospitalised patients, is a considerable challenge for medical personnel (hospital environment) who have direct contact with the patient, as well as being of interest to public health specialists. Financial issues related to the occurrence of the above-mentioned micro-organism are being increasingly raised. Due to the scale of the phenomenon, we are beginning to pay attention to the significant system costs caused by the diagnosis and treatment of CDI infection and its complications. Studies indicate that the nosocomial infection of C. difficile complicates hospitalisation, by increasing the cost by more than half and extending patient’s stay by an average of 3.6 days. Material and methods: The aim of this study was to attempt to calculate the estimated costs associated with the prolonged hospitalisation of patients with nosocomial CDI infection, using the example of a hospital in Lodz. A total of 53 completed hospitalisations of patients treated in the period of January–August 2018 were analysed, during which hospital Clostridioides difficile infection was identified. For the purposes of this study, statistical data collected in the hospital’s IT system were also analysed, covering 44,868 hospitalisations in the Jan–Aug 2018 period, during which no hospital infection occurred. They was a control group, in which the analysed cases were compared. The obtained data in the study determined how long each patient with Clostridioides difficile infection stayed in the hospital (from the moment infection was diagnosed until the day of hospital discharge), and which diagnosis related groups (DRG) (according to National Health Fund guidelines) were assigned. The average length of patient stay without infection within a given DRG group in each hospital ward was also determined. The collected materials became the initial point for the final analysis of hospital costs and the length of hospital stay caused by Clostridioides difficile infection. Results: Clostridioides difficile infection extended the hospital stay by an average of almost 12 days. The average cost of prolonged hospitalisation due to CDI infection (according to the average cost per person-day) was about PLN 7148 (1664 EUR), which gave a total value of about PLN 378,860.6 (88,240.5 EUR) in the examined period. At the same time, the average expenditure from the National Health Fund for hospitalisation due to CDI infections increased by about PLN 6627 (1542.8 EUR), which in the analysed period translated into over PLN 351,232.0 (81,505.5 EUR) (according to settlements with the National Health Fund). The outcome indicates that there is a clear relation between CDI and the anticipated length of hospitalisation of patients without an infection.

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Section: Discussionmentioning

confidence: 99%

Costs Associated with the Treatment of Clostridioides Difficile Infections

Sierocka

Kiersnowska

Lemiech-Mirowska

et al. 2021

IJERPH

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“…Clostridioides difficile infection (CDI) is one of the most frequently reported hospital-acquired infections (HAIs) in European countries, accounting for 3.6% of all HAIs and 48% of all gastro-intestinal infections, both HA and non-HA (excluding hepatitis) [ 1 ]. With such high incidence rates, healthcare resource use and attributable financial burden of CDI are significant, mainly driven by length of hospital stay [ 2 – 4 ]. Retrospective cost analyses in various European countries estimated mean CDI attributable direct costs per hospital stay of €4396 to €14,023 [ 5 – 7 ].…”

Section: Introductionmentioning

confidence: 99%

Analysis of C. difficile infection–related outcomes in European participants in the bezlotoxumab MODIFY I and II trials

Bouza

Cornely

Ramos‐Martínez

et al. 2020

Eur J Clin Microbiol Infect Dis

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The MODIFY I/II trials demonstrated that bezlotoxumab, a human monoclonal antibody against Clostridioides difficile toxin B, given during antibiotic treatment for Clostridioides difficile infection (CDI) significantly reduced C. difficile recurrence (rCDI) in adults at high risk for rCDI. Efficacy of CDI-directed intervention may depend on ribotype regional epidemiology, and patient characteristics. This post hoc analysis assessed the efficacy of bezlotoxumab in the subgroup of MODIFY I/II trial participants enrolled in Europe. Data from the bezlotoxumab (10 mg/kg single intravenous infusion) and placebo (0.9% saline) groups from MODIFY I/II were compared to assess initial clinical cure (ICC), rCDI, all-cause, and CDI-associated rehospitalizations within 30 days of discharge, and mortality through 12 weeks post-infusion. Of 1554 worldwide participants, 606 were from Europe (bezlotoxumab n = 313, 51%; placebo n = 292; 48%). Baseline characteristics were generally similar across groups, although there were more immunocompromised participants in the bezlotoxumab group (27.2%) compared with placebo (20.1%). Fifty-five percent of participants were female, and 86% were hospitalized at randomization. The rate of ICC was similar between treatment groups. The rate of rCDI in the bezlotoxumab group was lower compared with placebo among European participants overall, and among those with ≥ 1 risk factor for rCDI. Bezlotoxumab reduced 30-day CDI-associated rehospitalizations compared with placebo. These results are consistent with overall results from the MODIFY trials and demonstrate that bezlotoxumab reduces rCDI and CDI-associated rehospitalizations in European patients with CDI. MODIFY I/II (NCT01241552 and NCT01513239)

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“…The burden of C. difficile infection (CDI) is known to be particularly high in frail elderly, in term of short [2] and long-term mortality [3], but also of quality of life [4] and financial cost [5]. Despite such recognized burden of CDI, limited research exist on its prognostic impact on the most frequent diseases that require antimicrobial treatment.…”

Section: Introductionmentioning

confidence: 99%