Hospital Universitario Puerta de Hierro, C/ Manuel de Falla 1, Majadahonda 28222, Madrid, Spain; University Francisco de Vitoria, Madrid, Spain.
National Institute for Infectious Diseases "L. Spallanzani", Rome, Italy.
Int J Infect Dis. 2015 Jul;36:31-8. doi: 10.1016/j.ijid.2015.05.013. Epub 2015 May 21.
To assess the impact of Clostridium difficile infection (CDI) on hospital resources and costs in Spain and Italy.
CDI data were collected from institutions in Spain and Italy. Each patient was matched with two randomly selected uninfected controls in the same institution. Patient outcomes were assessed for the first and second episodes of CDI and for patients aged ≤65 and >65 years. The impact of CDI on hospital length of stay (LOS) was used to calculate CDI-attributable costs. A multivariate analysis using duration of stay as the continuous outcome variable assessed the independent effect of CDI on hospital costs and LOS.
LOS attributable to CDI ranged from 7.6-19.0 days in adults and was 5.0 days in children; the increases were greater in adults in Italy than in Spain. Attributable costs per adult patient ranged from €4396 in Madrid to €14 023 in Rome, with the majority of the cost being due to hospitalization. For children, the total attributable cost was €3545/patient.
These data show that the burden of CDI is considerable in Spain and Italy. Treatments that can reduce LOS, disease severity, and recurrence rates, as well as effective infection control measures to prevent transmission, have the potential to reduce the burden of CDI.
评估艰难梭菌感染（CDI）对西班牙和意大利医院资源和成本的影响。
从西班牙和意大利的医疗机构收集 CDI 数据。每个患者与同一机构中随机选择的两名未感染对照患者相匹配。评估了 CDI 第一和第二发作以及年龄≤65 岁和>65 岁患者的患者结局。使用住院时间来计算 CDI 相关成本，以评估 CDI 对住院费用和住院时间的独立影响。使用住院时间作为连续结果变量的多元分析评估了 CDI 对住院费用和住院时间的独立影响。
成人归因于 CDI 的住院时间范围为 7.6-19.0 天，儿童为 5.0 天；意大利的成年人比西班牙的成年人增加更多。每位成年患者的归因费用从马德里的 4396 欧元到罗马的 14023 欧元不等，大部分费用归因于住院治疗。对于儿童，总归因费用为 3545 欧元/患者。
这些数据表明，CDI 在西班牙和意大利的负担相当大。能够降低 LOS、疾病严重程度和复发率的治疗方法，以及有效的感染控制措施以预防传播，有可能减轻 CDI 的负担。
