Barrero Liliana I, Castillo Juan S, Leal Aura L, Sánchez Ricardo, Cortés Jorge A, Alvarez Carlos A, González Andrés L
Grupo de Investigación en Enfermedades Infecciosas, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C, Colombia.
Grupo para el Control de la Resistencia Bacteriana de Bogotá (GREBO), Bogotá, D.C, Colombia.
Biomedica. 2014 Jul-Sep;34(3):345-53. doi: 10.1590/S0120-41572014000300005.
Resistant infections, especially those involving the bloodstream, are associated with a greater use of resources. Their estimates are variable and depend on the methodology used. Staphylococcus aureus is the main pathogen isolated in blood in our hospitals. There is no consolidated data about economic implications of methicillin-resistant S. aureus infection.
To describe the cost of care of methicillin-resistant S. aureus bacteremia in a reference population from nine hospitals in Bogotá. Materials y methods: A multicenter cohort study included 204 patients in a 1:1 ratio according to resistance. Direct medical costs were calculated from hospitalization bills, while the bacteremia period was calculated by applying microcosting based on standard fares.
We found no significant differences between groups in demographic and clinical characteristics, except for resistance risk factors. Fifty-three percent of patients died during hospitalization. Hospital stay and total invoiced value during hospitalization were significantly higher in the group with methicillin-resistant S. aureus bacteremia. For this group, higher costs in ICU stay, antibiotics use, intravenous fluids, laboratory tests and respiratory support were recorded. A crude increase of 31% and an adjusted increase of 70% in care costs associated with methicillin resistance were registered.
Our study supports decision makers in finding and funding infection prevention programs, especially those infections caused by resistant organisms.
耐药性感染,尤其是涉及血流的感染,与更多的资源使用相关。其估计值存在差异,且取决于所使用的方法。金黄色葡萄球菌是我们医院血液中分离出的主要病原体。关于耐甲氧西林金黄色葡萄球菌感染的经济影响,尚无统一的数据。
描述波哥大九家医院参考人群中耐甲氧西林金黄色葡萄球菌菌血症的护理成本。材料与方法:一项多中心队列研究纳入了204例患者,根据耐药性按1:1比例分组。直接医疗成本根据住院账单计算,而菌血症期则通过基于标准费用的微观成本核算来计算。
除耐药危险因素外,两组在人口统计学和临床特征方面无显著差异。53%的患者在住院期间死亡。耐甲氧西林金黄色葡萄球菌菌血症组的住院时间和住院期间的总开票金额显著更高。对于该组,在重症监护病房停留、抗生素使用、静脉输液、实验室检查和呼吸支持方面记录到更高的成本。与耐甲氧西林相关的护理成本粗略增加了31%,调整后增加了70%。
我们的研究为决策者寻找和资助感染预防项目提供了支持,尤其是那些由耐药微生物引起的感染。