Socioeconomic Burden of Bloodstream Infections Caused by Carbapenem-Resistant .

BACKGROUND

Although infection with carbapenem-resistant () has become an urgent public health threat worldwide, the socioeconomic burden of bloodstream infection (BSI) remains to be clarified.

METHODS

This retrospective study included all patients infected with or who were hospitalized for BSI from 2013 to 2015. Socioeconomic burden, including direct and indirect economic burden, was compared in patients infected with carbapenem-sensitive () and following 1:1 propensity score matching (PSM) to control for confounding variables.

RESULTS

Data from 879 patients with BSI were evaluated, including 152 (17.3%) patients infected with and 727 (82.7%) infected with . PSM yielded 112 pairs of 224 patients. Median hospital length of stay did not differ significantly in the and groups (35 vs 29 days, P = 0.089), but in-hospital 28-day mortality rate was significantly higher in patients infected with than with (45.5% vs 32.1%, P = 0.040). Median direct economic burden was significantly greater in patients with BSI than with BSI during hospitalization ($24,940.1 vs 16,864.0, P = 0.017) but not during the period after infection ($10,403.4 vs 8498.0, P = 0.178). Drug expenditure accounted for the largest proportion of costs in both groups. The median disability-adjusted life year (DALY) was higher in -BSI than in BSI patients, but the difference was not statistically significant (7.9 vs 6.7 years, P = 0.190). Median indirect economic burden did not differ significantly in these two groups ($3848.5 vs 1139.9, P = 0.304), although indirect economic burden increased significantly from 2013 to 2015 in patients with -BSI.

CONCLUSION

Carbapenem resistance had a major impact on the clinical and socioeconomic burden of patients with BSI. The higher mortality rate in patients with -BSI was associated with increased direct healthcare burden and indirect socioeconomic loss.