Hospital and related resource costs associated with antimicrobial-resistant infections in Canada, 2019

Antimicrobial resistance (AMR) occurs when microorganisms become resistant to treatment by standard, or first-line, antibiotic drugs. These infections create an enormous burden on society due to longer hospital stays and increased morbidity and mortality, resulting in increased medical costs and foregone resources. The objective of this paper is to estimate the hospital costs associated with two of the most significant antibiotic-resistant organisms: methicillin-resistant Staphylococcus aureus (MRSA) and Clostridioides difficile (C. difficile), for Canada, for the year 2019, as well as the value of other resource use attributed to the lost production due to disability and premature mortality.

The Discharge Abstract Database was employed for the analysis using a two-step process: first, the number of cases for each diagnosis was estimated; and then an average cost per case was derived, which was used to multiply the number of cases to obtain the total costs. Costs were derived using a regression model, accounting for demographic and other important confounding variables.

There were a total of 16,070 and 9,889 cases of C. difficile infections and MRSA infections, respectively, in Canada in 2019, resulting in an estimated 1,743 premature deaths. The majority of cases occurred in the older age groups. The hospital costs attributable to these infections were over $125 million, while the indirect resource costs were between $18.8 and $146.9 million.

Quantifying the outcomes associated with antimicrobial-resistant infections provides valuable information for policymakers and is an essential first step in understanding the total economic impacts of AMR.