Alfa Institute of Biomedical Sciences, 9 Neapoleos Street, 151 23 Marousi, Athens, Greece.
Expert Rev Anti Infect Ther. 2013 Mar;11(3):321-31. doi: 10.1586/eri.13.4.
This article evaluates the in-hospital costs attributable to antimicrobial multidrug resistance, defined as the difference in averaged costs of the patients infected with a multidrug-resistant (MDR) versus a non-MDR organism. PubMed and Scopus databases were searched to identify relevant studies. Twenty four studies were included: four on carbapenem-resistant or MDR Gram negative nonfermenters, eight on extended-spectrum b-lactamase-producing Enterobacteriaceae and 12 on methicillin-resistant Staphylococcus aureus. In two studies on carbapenem-resistant nonfermenters, the attributable mean hospital charges were US$58,457 and 85,299, respectively. The attributable mean total costs were US$4484 in a study referring to MDR Acinetobacter baumannii, while that varied from US$1584 to 30,093 among studies on extended-spectrum b-lactamase-producing Enterobacteriaceae. With respect to methicillin-resistant S. aureus, the attributable mean total costs varied from US$1014 to 40,090. The in-hospital costs attributable to multidrug resistance are alarmingly high, justifying the application of strict infection control measures in medical institutions with increased rate of MDR infections.
本文评估了与抗菌药物多药耐药相关的住院费用，其定义为感染多药耐药（MDR）与非 MDR 病原体的患者平均成本差异。检索了 PubMed 和 Scopus 数据库以确定相关研究。共纳入 24 项研究：4 项关于碳青霉烯类耐药或 MDR 革兰氏阴性非发酵菌，8 项关于产超广谱β-内酰胺酶的肠杆菌科，12 项关于耐甲氧西林金黄色葡萄球菌。在 2 项关于碳青霉烯类耐药非发酵菌的研究中，归因的平均住院费用分别为 58457 美元和 85299 美元。在一项关于 MDR 鲍曼不动杆菌的研究中，归因的平均总费用为 4484 美元，而在关于产超广谱β-内酰胺酶的肠杆菌科的研究中，这一费用从 1584 美元到 30093 美元不等。对于耐甲氧西林金黄色葡萄球菌，归因的平均总费用从 1014 美元到 40090 美元不等。与多药耐药相关的住院费用高得惊人，这证明了在 MDR 感染率增加的医疗机构中应用严格的感染控制措施是合理的。
