How Should Economic Analyses Inform Nosocomial Infection Control?

Mylonakis, Eleftherios; Ziakas, Panayiotis D

doi:10.1001/amajethics.2021.631

Cited by 4 publications

(2 citation statements)

References 31 publications

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“…Concerning surgical ICU infections, NIs are a major concern because they contribute to increased morbidity and mortality rates [ 7 , 8 , 12 – 14 ]. In addition, NIs can cause postoperative complications, extend hospital stays by up to 13 days, and increase healthcare costs [ 15 – 17 ]. The presence of NIs has a detrimental effect on both patient and healthcare worker safety [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Nosocomial infections in the surgical intensive care unit: an observational retrospective study from a large tertiary hospital in Palestine

Aiesh,

Qashou,

Shemmessian

et al. 2023

BMC Infect Dis

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Background Nosocomial infections or hospital-acquired infections are a growing public health threat that increases patient morbidity and mortality. Patients at the highest risk are those in intensive care units. Therefore, our objective was to provide a pattern analysis of nosocomial infections that occurred in an adult surgical intensive care unit (ICU). Methods This study was a retrospective observational study conducted in a 6-bed surgical intensive care unit (SICU) at An-Najah National University Hospital (NNUH) to detect the incidence of nosocomial infections from January 2020 until December 2021. The study group included 157 patients who received antibiotics during their stay in the SICU. Results The incidence of nosocomial infections, either suspected or confirmed, in the SICU was 26.9% (95 out of 352 admitted patients). Pneumonia (36.8%) followed by skin and soft tissue infections (35.8%) were the most common causes. The most common causative microorganisms were in the following order: Pseudomonas aeruginosa (26.3%), Acinetobacter baumannii (25.3%), extended-spectrum beta lactamase (ESBL)-Escherichia coli (23.2%) and Klebsiella pneumonia (15.8%). The average hospital stay of patients with nosocomial infections in the SICU was 18.5 days. Conclusions The incidence of nosocomial infections is progressively increasing despite the current infection control measures, which accounts for an increased mortality rate among critically ill patients. The findings of this study may be beneficial in raising awareness to implement new strategies for the surveillance and prevention of hospital-acquired infections in Palestinian hospitals and health care centers.

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Section: Introductionmentioning

confidence: 99%

Nosocomial infections in the surgical intensive care unit: an observational retrospective study from a large tertiary hospital in Palestine

Aiesh,

Qashou,

Shemmessian

et al. 2023

BMC Infect Dis

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“… 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 Evidence-based clinical management by an ID specialist allows for early source control, which is associated with reduced complications and recurrence 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 and potentially lower health care expenditures. Given the current emphasis among clinical decision-makers on high-value affordable care 18 , 19 , 20 that aims to optimize allocation of resources while improving patient outcomes, the aim of this study was to perform a cost-effectiveness analysis comparing use of ID consultation with no ID consultation for the management of SAB.…”

Section: Introductionmentioning

confidence: 99%

Economic Analysis of Infectious Disease Consultation forStaphylococcus aureusBacteremia Among Hospitalized Patients

2022

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ImportanceStaphylococcus aureus bacteremia is associated with a significant burden of mortality, morbidity, and health care costs. Infectious disease consultation may be associated with reduced mortality and bacteremia recurrence rates.ObjectiveTo evaluate the cost-effectiveness of infectious disease consultation for Staphylococcus aureus bacteremia.Design, Setting, and ParticipantsIn this economic evaluation, a decision-analytic model was constructed comparing infectious disease consult with no consult. The population was adult hospital inpatients with Staphylococcus aureus bacteremia diagnosed with at least 1 positive blood culture. Cost-effectiveness was calculated as deaths averted and incremental cost-effectiveness ratios. Uncertainty was addressed by plotting cost-effectiveness planes and acceptability curves for various willingness-to-pay thresholds. Costs and outcomes were calculated for a time horizon of 6 months. The analysis was performed from a societal perspective and included studies that had been published by January 2022.InterventionsPatients received or did not receive formal bedside consultation after positive blood cultures for Staphylococcus aureus bacteremia.Main Outcomes and MeasuresThe main outcomes were incremental difference in effectiveness (survival probabilities), incremental difference in cost (US dollars) and incremental cost-effectiveness ratios (US dollars/deaths averted).ResultsThis model included 1708 patients who received consultation and 1273 patients who did not. In the base-case analysis, the cost associated with the infectious disease consult strategy was $54 137.4 and the associated probability of survival was 0.77. For the no consult strategy, the cost was $57 051.2, and the probability of survival was 0.72. The incremental difference in cost between strategies was $2913.8, and the incremental difference in effectiveness was 0.05. Overall, consultation was associated with estimated savings of $55 613.4/death averted (incremental cost-effectiveness ratio, −$55613.4/death averted). In the probabilistic analysis, at a willingness-to-pay threshold of $50 000, infectious disease consult was cost-effective compared with no consult in 54% of 10 000 simulations. In cost-effectiveness acceptability curves, the consult strategy was cost-effective in 58% to 73%) of simulations compared with no consult for a willingness-to-pay threshold ranging from $0 to $150 000.Conclusions and RelevanceThese findings suggest that infectious disease consultation may be a cost-effective strategy for management of Staphylococcus aureus bacteremia and that it is associated with health care cost-savings.

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Estimating the savings of a national project to prevent healthcare-associated infections in intensive care units

Oliveira,

de Sousa,

de Salvo

et al. 2024

Journal of Hospital Infection

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How Should Economic Analyses Inform Nosocomial Infection Control?

Cited by 4 publications

References 31 publications

Nosocomial infections in the surgical intensive care unit: an observational retrospective study from a large tertiary hospital in Palestine

Nosocomial infections in the surgical intensive care unit: an observational retrospective study from a large tertiary hospital in Palestine

Economic Analysis of Infectious Disease Consultation forStaphylococcus aureusBacteremia Among Hospitalized Patients

Estimating the savings of a national project to prevent healthcare-associated infections in intensive care units

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