Department of Nosocomial Infection, University of Chinese Academy of Sciences, Shenzhen Hospital.
Inspection Center, Guangming District Center for Disease Control and Prevention, Shenzhen, Guangdong, China.
Medicine (Baltimore). 2021 Apr 16;100(15):e25440. doi: 10.1097/MD.0000000000025440.
Hospital-acquired pneumonia (HAP) caused by Klebsiella pneumonia (KP) is a common nosocomial infection (NI). However, the reports on the economic burden of hospital-acquired pneumonia caused by Klebsiella pneumonia (KP-HAP) were scarce. The study aims to study the direct economic loss caused by KP-HAP with the method of propensity score matching (PSM) to provide a basis for the cost accounting of NI and provide references for the formulation of infection control measures.
A retrospective investigation was conducted on the hospitalization information of all patients discharged from a tertiary group hospital in Shenzhen, Guangdong province, China, from June 2016 to August 2019. According to the inclusion and exclusion criteria, patients were divided into the HAP group and noninfection group, the extended-spectrum beta-lactamases (ESBLs) positive KP infection group, and the ESBLs-negative KP infection group. After the baselines of each group were balanced with the PSM, length of stay (LOS) and hospital cost of each group were compared.
After the PSM, there were no differences in the baselines of each group. Compared with the noninfection group, the median LOS in the KP-HAP group increased by 15 days (2.14 times), and the median hospital costs increased by 7329 yuan (0.89 times). Compared with the ESBLs-negative KP-HAP group, the median LOS in the ESBLs-positive KP-HAP group increased by 7.5 days (0.39 times), and the median hospital costs increased by 22,424 yuan (1.90 times).
KP-HAP prolonged LOS and increased hospital costs, and HAP caused by ESBLs-positive KP had more economic losses than ESBLs-negative, which deserves our attention and should be controlled by practical measures.
肺炎克雷伯菌(KP)引起的医院获得性肺炎(HAP)是一种常见的医院获得性感染(NI)。然而,关于肺炎克雷伯菌引起的医院获得性肺炎(KP-HAP)经济负担的报告很少。本研究旨在采用倾向评分匹配(PSM)方法研究 KP-HAP 引起的直接经济损失,为 NI 的成本核算提供依据,并为感染控制措施的制定提供参考。
对 2016 年 6 月至 2019 年 8 月期间在中国广东省深圳市某三级综合医院出院的所有患者的住院信息进行回顾性调查。根据纳入和排除标准,将患者分为 HAP 组和非感染组、产超广谱β-内酰胺酶(ESBLs)阳性 KP 感染组和 ESBLs 阴性 KP 感染组。对各组进行 PSM 后,比较各组的住院时间(LOS)和住院费用。
PSM 后,各组基线无差异。与非感染组相比,KP-HAP 组 LOS 中位数增加 15 天(2.14 倍),住院费用中位数增加 7329 元(0.89 倍)。与 ESBLs 阴性 KP-HAP 组相比,ESBLs 阳性 KP-HAP 组 LOS 中位数增加 7.5 天(0.39 倍),住院费用中位数增加 22424 元(1.90 倍)。
KP-HAP 延长了 LOS 并增加了住院费用,且 ESBLs 阳性 KP 引起的 HAP 比 ESBLs 阴性的经济损失更大,值得我们关注,并应采取切实可行的措施加以控制。