Economic Burden of Multidrug-Resistant Gram-Negative Infections in a Developing Country
Objective: Antibiotic-resistant infections represent a significant global public health threat due to their rising prevalence. The aim of this study is to identify risk factors for acquisition of multidrug-resistant gram negatives (MDR-GNs) in the first intensive care unit (ICU) infection episode of...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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KARE Publishing
2019-09-01
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| Series: | Erciyes Medical Journal |
| Subjects: | |
| Online Access: | https://jag.journalagent.com/z4/download_fulltext.asp?pdir=erciyesmedj&un=EMJ-43179 |
| _version_ | 1828026599398703104 |
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| author | Aysegul Ulu Kılıç Gamze Kalin Unuvar Fatma Cevahir Emine Alp |
| author_facet | Aysegul Ulu Kılıç Gamze Kalin Unuvar Fatma Cevahir Emine Alp |
| author_sort | Aysegul Ulu Kılıç |
| collection | DOAJ |
| description | Objective: Antibiotic-resistant infections represent a significant global public health threat due to their rising prevalence. The aim of this study is to identify risk factors for acquisition of multidrug-resistant gram negatives (MDR-GNs) in the first intensive care unit (ICU) infection episode of patients and also to calculate the economic burden of infection with MDR-GNs that the ICU patient faced.
Materials and Methods: This is a prospective observational study conducted over 1 year. The first ICU infection episode of the patients was included into this study. A case was defined as a patient who had an MDR-GN in his or her first episode of an ICU infection, and control was defined as a patient who had a non-MDR-GN in his or her first episode of an ICU infection.
Results: A total of 100 patients were included into the study. Sixty-two patients had the MDR-GN, and 38 patients had a non-MDR pathogen. Independent risk factors associated with the MDR-GN infection were the APACHE II score (OR=1.08, p=0.012), transfer from another hospital (OR=9.3, p=0.04), antibiotic use before ICU infection (OR=7.7, p=0.04), and arterial catheter (OR=2.8, p=0.03). The median antibiotic cost was significantly higher for patients in the case group [$663.50 (27–3,752) and $256.00 (0–2,716), respectively] (p<0.01). Also, a total hospital cost for patients was significantly higher in the case group ($8,895 [2,621–23,883] and $6,551 [1,441–20,425], respectively) (p<0.05).
Conclusion: Patients with a high APACHE II score transferred from another hospital and who use an antibiotic before the ICU infection and arterial catheter are at a greater risk of MDR-GN infections. Also, the infections pose a significant burden on health care facilities due to more prolonged and costly treatments. |
| first_indexed | 2024-04-10T13:23:00Z |
| format | Article |
| id | doaj.art-d92dc4b600414204b45e98de9a857528 |
| institution | Directory Open Access Journal |
| issn | 2149-2247 |
| language | English |
| last_indexed | 2024-04-10T13:23:00Z |
| publishDate | 2019-09-01 |
| publisher | KARE Publishing |
| record_format | Article |
| series | Erciyes Medical Journal |
| spelling | doaj.art-d92dc4b600414204b45e98de9a8575282023-02-15T16:12:00ZengKARE PublishingErciyes Medical Journal2149-22472019-09-0141331231510.14744/etd.2019.43179EMJ-43179Economic Burden of Multidrug-Resistant Gram-Negative Infections in a Developing CountryAysegul Ulu Kılıç0Gamze Kalin Unuvar1Fatma Cevahir2Emine Alp3Department of Infectious Diseases, Erciyes University Faculty of Medicine, Kayseri, TurkeyDepartment of Infectious Diseases, Erciyes University Faculty of Medicine, Kayseri, TurkeyInfection Control Committee, Erciyes University Faculty of Medicine, Kayseri, TurkeyRepublic of Turkey, Ministry of Health, Ankara, TurkeyObjective: Antibiotic-resistant infections represent a significant global public health threat due to their rising prevalence. The aim of this study is to identify risk factors for acquisition of multidrug-resistant gram negatives (MDR-GNs) in the first intensive care unit (ICU) infection episode of patients and also to calculate the economic burden of infection with MDR-GNs that the ICU patient faced. Materials and Methods: This is a prospective observational study conducted over 1 year. The first ICU infection episode of the patients was included into this study. A case was defined as a patient who had an MDR-GN in his or her first episode of an ICU infection, and control was defined as a patient who had a non-MDR-GN in his or her first episode of an ICU infection. Results: A total of 100 patients were included into the study. Sixty-two patients had the MDR-GN, and 38 patients had a non-MDR pathogen. Independent risk factors associated with the MDR-GN infection were the APACHE II score (OR=1.08, p=0.012), transfer from another hospital (OR=9.3, p=0.04), antibiotic use before ICU infection (OR=7.7, p=0.04), and arterial catheter (OR=2.8, p=0.03). The median antibiotic cost was significantly higher for patients in the case group [$663.50 (27–3,752) and $256.00 (0–2,716), respectively] (p<0.01). Also, a total hospital cost for patients was significantly higher in the case group ($8,895 [2,621–23,883] and $6,551 [1,441–20,425], respectively) (p<0.05). Conclusion: Patients with a high APACHE II score transferred from another hospital and who use an antibiotic before the ICU infection and arterial catheter are at a greater risk of MDR-GN infections. Also, the infections pose a significant burden on health care facilities due to more prolonged and costly treatments.https://jag.journalagent.com/z4/download_fulltext.asp?pdir=erciyesmedj&un=EMJ-43179economic burdengram negativesdeveloping country |
| spellingShingle | Aysegul Ulu Kılıç Gamze Kalin Unuvar Fatma Cevahir Emine Alp Economic Burden of Multidrug-Resistant Gram-Negative Infections in a Developing Country Erciyes Medical Journal economic burden gram negatives developing country |
| title | Economic Burden of Multidrug-Resistant Gram-Negative Infections in a Developing Country |
| title_full | Economic Burden of Multidrug-Resistant Gram-Negative Infections in a Developing Country |
| title_fullStr | Economic Burden of Multidrug-Resistant Gram-Negative Infections in a Developing Country |
| title_full_unstemmed | Economic Burden of Multidrug-Resistant Gram-Negative Infections in a Developing Country |
| title_short | Economic Burden of Multidrug-Resistant Gram-Negative Infections in a Developing Country |
| title_sort | economic burden of multidrug resistant gram negative infections in a developing country |
| topic | economic burden gram negatives developing country |
| url | https://jag.journalagent.com/z4/download_fulltext.asp?pdir=erciyesmedj&un=EMJ-43179 |
| work_keys_str_mv | AT aysegululukılıc economicburdenofmultidrugresistantgramnegativeinfectionsinadevelopingcountry AT gamzekalinunuvar economicburdenofmultidrugresistantgramnegativeinfectionsinadevelopingcountry AT fatmacevahir economicburdenofmultidrugresistantgramnegativeinfectionsinadevelopingcountry AT eminealp economicburdenofmultidrugresistantgramnegativeinfectionsinadevelopingcountry |