The impact of carbapenem-resistant Pseudomonas aeruginosa on clinical and economic outcomes in a Chinese tertiary care hospital: A propensity score-matched analysis.

BACKGROUND

This study aimed to estimate the impact of carbapenem-resistant Pseudomonas aeruginosa (CRPA) on clinical and economic outcomes in a Chinese tertiary care hospital.

METHODS

Patients were assigned to a carbapenem-susceptible P aeruginosa group or to a CRPA group and matched using propensity score matching. In-hospital mortality, length of stay (LOS), LOS after culture, total hospital costs, daily hospital cost, and 30-day readmission were comparatively analyzed. Subgroup analysis was performed to determine the associations between the subgrouping factors and in-hospital mortality in patients with CRPA isolates.

RESULTS

Within the propensity-matched cohort, in-hospital mortality (12.6% vs 7.8%; P   =   .044), LOS (median 29.0 vs 25.5 days; P   =   .026), LOS after culture (median 18.5 vs 14.0 days; P   =   .029), total hospital costs (median $6,082.0 vs $4,954.2; P  =  .015), and daily hospital cost (median $236.1 vs $223.6; P  =  .045) were significantly higher in CRPA patients than in carbapenem-susceptible P aeruginosa patients. Subgroup analysis revealed a significant interaction between CRPA and age (P  =  .009).

CONCLUSION

Prevention and control of CRPA among hospitalized patients, especially among those over the age of 65 years, is a good measurement for the reduction of mortality and medical costs derived from CRPA infection or colonization.