We performed a multicentre retrospective cohort study including 606,649 acute inpatient episodes at 10 European hospitals in 2010 and 2011 to estimate the impact of antimicrobial resistance on hospital mortality, excess length of stay (LOS) and cost. Bloodstream infections (BSI) caused by third-generation cephalosporin-resistant Enterobacteriaceae (3GCRE), meticillin-susceptible (MSSA) and-resistant Staphylococcus aureus (MRSA) increased the daily risk of hospital death (adjusted hazard ratio (HR) = 1.80; 95% confidence interval (CI): 1.34-2.42, HR = 1.81; 95% CI: 1.49-2.20 and HR = 2.42; 95% CI: 1.66-3.51, respectively) and prolonged LOS (9.3 days; 95% CI: 9.2-9.4, 11.5 days; 95% CI: 11.5-11.6 and 13.3 days; 95% CI: 13.2-13.4, respectively). BSI with third-generation cephalosporinsusceptible Enterobacteriaceae (3GCSE) significantly increased LOS (5.9 days; 95% CI: 5.8-5.9) but not hazard of death (1.16; 95% CI: 0.98-1.36). 3GCRE significantly increased the hazard of death (1.63; 95% CI: 1.13-2.35), excess LOS (4.9 days; 95% CI: 1.1-8.7) and cost compared with susceptible strains, whereas meticillin resistance did not. The annual cost of 3GCRE BSI was higher than of MRSA BSI. While BSI with S. aureus had greater impact on mortality, excess LOS and cost than Enterobacteriaceae per infection, the impact of antimicrobial resistance was greater for Enterobacteriaceae.

Stewardson, A. J., Allignol, A., Beyersmann, J., Graves, N., Schumacher, M., Meyer, R., Tacconelli, E., De Angelis, G., Farina, C., Pezzoli, F., Bertrand, X., Gbaguidi-Haore, H., Edgeworth, J., Tosas, O., Martinez, J. A., Ayala-Blanco, M. P., Pan, A., Zoncada, A., Marwick, C. A., Nathwani, D., Seifert, H., Hos, N., Hagel, S., Pletz, M., Harbarth, S., Masuet-Aumatell, C., Navarro, M. B., Falcone, C., The health and economic burden of bloodstream infections caused by antimicrobial-susceptible and non-susceptible Enterobacteriaceae and Staphylococcus aureus in European hospitals, 2010 and 2011: A multicentre retrospective cohort study, <<EUROSURVEILLANCE>>, 2016; 21 (33): 5-16. [doi:10.2807/1560-7917.ES.2016.21.33.30319] [http://hdl.handle.net/10807/172132]

The health and economic burden of bloodstream infections caused by antimicrobial-susceptible and non-susceptible Enterobacteriaceae and Staphylococcus aureus in European hospitals, 2010 and 2011: A multicentre retrospective cohort study

Tacconelli, Evelina;De Angelis, Giulia;
2016

Abstract

We performed a multicentre retrospective cohort study including 606,649 acute inpatient episodes at 10 European hospitals in 2010 and 2011 to estimate the impact of antimicrobial resistance on hospital mortality, excess length of stay (LOS) and cost. Bloodstream infections (BSI) caused by third-generation cephalosporin-resistant Enterobacteriaceae (3GCRE), meticillin-susceptible (MSSA) and-resistant Staphylococcus aureus (MRSA) increased the daily risk of hospital death (adjusted hazard ratio (HR) = 1.80; 95% confidence interval (CI): 1.34-2.42, HR = 1.81; 95% CI: 1.49-2.20 and HR = 2.42; 95% CI: 1.66-3.51, respectively) and prolonged LOS (9.3 days; 95% CI: 9.2-9.4, 11.5 days; 95% CI: 11.5-11.6 and 13.3 days; 95% CI: 13.2-13.4, respectively). BSI with third-generation cephalosporinsusceptible Enterobacteriaceae (3GCSE) significantly increased LOS (5.9 days; 95% CI: 5.8-5.9) but not hazard of death (1.16; 95% CI: 0.98-1.36). 3GCRE significantly increased the hazard of death (1.63; 95% CI: 1.13-2.35), excess LOS (4.9 days; 95% CI: 1.1-8.7) and cost compared with susceptible strains, whereas meticillin resistance did not. The annual cost of 3GCRE BSI was higher than of MRSA BSI. While BSI with S. aureus had greater impact on mortality, excess LOS and cost than Enterobacteriaceae per infection, the impact of antimicrobial resistance was greater for Enterobacteriaceae.
2016
Inglese
Stewardson, A. J., Allignol, A., Beyersmann, J., Graves, N., Schumacher, M., Meyer, R., Tacconelli, E., De Angelis, G., Farina, C., Pezzoli, F., Bertrand, X., Gbaguidi-Haore, H., Edgeworth, J., Tosas, O., Martinez, J. A., Ayala-Blanco, M. P., Pan, A., Zoncada, A., Marwick, C. A., Nathwani, D., Seifert, H., Hos, N., Hagel, S., Pletz, M., Harbarth, S., Masuet-Aumatell, C., Navarro, M. B., Falcone, C., The health and economic burden of bloodstream infections caused by antimicrobial-susceptible and non-susceptible Enterobacteriaceae and Staphylococcus aureus in European hospitals, 2010 and 2011: A multicentre retrospective cohort study, <<EUROSURVEILLANCE>>, 2016; 21 (33): 5-16. [doi:10.2807/1560-7917.ES.2016.21.33.30319] [http://hdl.handle.net/10807/172132]
File in questo prodotto:
File Dimensione Formato  
172132OA.pdf

accesso aperto

Tipologia file ?: Versione Editoriale (PDF)
Licenza: Creative commons
Dimensione 292.97 kB
Formato Unknown
292.97 kB Unknown Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/172132
Citazioni
  • ???jsp.display-item.citation.pmc??? 69
  • Scopus 135
  • ???jsp.display-item.citation.isi??? 116
social impact