Economic burden of healthcare-associated infection due to carbapenem-resistant gram-negative bacilli in a tertiary general hospital of Qinghai Province

ABSTRACT

OBJECTIVE: To explore the prevalence of carbapenem-resistant gram-negative bacilli(CRO) infection and the economic burden in a tertiary general hospital of Qinghai province. METHODS: The clinical data, length of hospital stay and costs of hospitalization were retrospectively collected from the patients with Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa hospital-acquired infection who were hospitalized in Qinghai Provincial Hospital from Jan 2017 to Dec 2017. The patients were divided into the drug-resistant group and the non drug-resistant group according to the result of drug susceptibility testing. The length of hospital stay and hospitalization cost were compared between the two groups of patients. RESULTS: A total of 521 patients were involved in the study, 120 of who had CRO infection(the drug-resistant group), and 40 had carbapenem-sensitive organisms infection(the non drug-resistant group). The median length of hospital stay of the drug-resistant group was 19 days, the median total hospitalization cost was 31 292 yuan;the median length of hospital stay of the non drug-resistant group was 15 days, the median total hospitalization cost was 22 610 yuan, and there were significant differences between the two groups(P<0.05). Stratified analysis showed that the median length of hospital stay of the patients with carbapenem-resistant K.pneumoniae infection was 17 days, the medial total hospitalization cost 25 227 yuan, the length of hospital stay of the non drug-resistant group was 14 day, the median total hospitalization cost 20 326 yuan;the median lengths of hospital stay of the patients with respiratory tract infection and the patients with bloodstream infection were respectively 19 days and 30 days in the drug-resistant group, the median total hospitalization costs were respectively 30 315 yuan and 30 050 yuan;the median lengths of hospital stay of the patients with respiratory tract infection and the patients with bloodstream infection were respectively 15 days and 13 days in the non drug-resistant group, the median total hospitalization costs were respectively 21 562 yuan and 24 853 yuan, and there were significant differences(P<0.05). CONCLUSION: The hospital-acquired CRO infection may lead to the increase of length of hospital stay and hospitalization cost of the hospitalized patients as well as the economic burden. It is necessary to take effective measures to reduce the incidence of hospital-acquired CRO infection.