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Antimicrobial Synergy Testing by the Inkjet Printer-assisted Automated Checkerboard Array and the Manual Time-kill Method
Published on: April 18, 2019
Healthcare resource use in hospitalized patients with carbapenem-resistant Gram-negative infections
B Merrick1, M K I Tan1, K Bisnauthsing1
1Centre for Clinical Infection and Diagnostics Research (CIDR), King's College, London, UK; Guy's and St. Thomas' NHS Foundation Trust, London, UK.
Objectives:
Antimicrobial resistance (AMR) is a threat to global public health. Infections with resistant organisms are more challenging to treat, often delay patient recovery and can increase morbidity and mortality. Healthcare costs associated with treating patients with AMR organisms are poorly described. In particular, data for specific organisms, such as those harbouring carbapenem resistance, are lacking.
Methods:
This was a retrospective, matched (1:1), single-centre, cohort study at a Central London hospital, comparing costs and resource use of 442 adult inpatients infected with either carbapenem-sensitive (CSO) or carbapenem-resistant organisms (CRO) over a two-year period. Resource use and micro-costing data were obtained from the hospital Patient, Education and Research Costing System (PERCS), and included both direct and indirect costs.
Results:
Overall, the median healthcare-related cost of treating a patient with a CRO was more than double (£49,537 vs £19,299) that of treating a patient with a CSO. There were statistically significant increases in expenditure across 21 of 44 measured parameters including critical care costs, which accounted for the greatest proportion of overall costs in both groups. Infections were predominantly of the respiratory tract (41%) and caused by Pseudomonas aeruginosa (76%).
Conclusions:
Infection with CROs increases healthcare expenditure significantly. Many of the costs, including patient support, portering and catering, have been underappreciated in previous work. We additionally note that patients infected with CROs have longer hospital stays, and increased theatre operating times compared with patients infected with CSOs.
Insights
Treating infections with carbapenem-resistant organisms (CROs) more than doubles healthcare costs compared to carbapenem-sensitive organisms (CSOs). This highlights the significant economic burden of antimicrobial resistance, particularly in critical care.
Area of Science:
- Infectious Diseases
- Health Economics
- Microbiology
Background:
- Antimicrobial resistance (AMR) poses a significant global public health threat.
- Infections caused by resistant organisms are complex to manage, leading to prolonged illness and increased mortality.
- Limited data exists on the specific healthcare costs associated with treating carbapenem-resistant organisms (CROs).
Purpose of the Study:
- To compare the healthcare costs and resource utilization between patients infected with carbapenem-sensitive organisms (CSOs) and carbapenem-resistant organisms (CROs).
- To identify specific cost drivers associated with CRO infections.
Main Methods:
- A retrospective, matched (1:1) cohort study was conducted at a single London hospital.
- 442 adult inpatients were analyzed over two years, comparing those with CSO versus CRO infections.
- Micro-costing data, including direct and indirect costs, were obtained from the hospital's Patient, Education and Research Costing System (PERCS).
Main Results:
- The median healthcare cost for treating a CRO infection was more than double that of a CSO infection (£49,537 vs £19,299).
- Statistically significant cost increases were observed across 21 of 44 measured parameters, with critical care costs being the highest.
- Predominant infections included respiratory tract (41%) and Pseudomonas aeruginosa (76%).
Conclusions:
- Infection with CROs significantly elevates healthcare expenditure.
- Underappreciated costs, such as patient support, portering, and catering, contribute to the increased financial burden.
- Patients with CRO infections experienced longer hospital stays and increased operating theatre times compared to those with CSO infections.
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