King Teagan L, Rennert-May Elissa, Somayaji Ranjani, Leal Jenine, Black Jason E, Conly John M, Gregson Daniel
Department of Medicine, University of Calgary and Alberta Health Services, Calgary, AB, Canada.
Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, AB, Canada.
JAC Antimicrob Resist. 2024 Oct 25;6(5):dlae157. doi: 10.1093/jacamr/dlae157. eCollection 2024 Oct.
We evaluated the costs of susceptible and resistant bloodstream infections (BSIs) in adults. Secondary outcomes were the impact of BSI on length of stay (LOS), readmissions and death.
We examined a population-based retrospective cohort of blood cultures from 2011 to 2018 in Calgary, Canada, linked to microcosting and gross costing data. Propensity score matching was completed, and costs were compared between no BSI and BSI over 90 days using linear regression.
A total of 4581 BSIs in 89 673 adults experienced bacteraemia during the study period. The mean cost of an BSI at 90 days was $39 072 (SD: $95 747) in adults. Ceftriaxone-resistant (CRO-R) , resistant to fluoroquinolones (FQ) and trimethoprim/sulfamethoxazole, compared with susceptible BSI resulted in the greatest mean cost at $53 899 and the highest odds of readmission, increased LOS, and death.
BSI is associated with substantial costs. Total cost differences were highest in those with CRO-R with resistance to FQ and trimethoprim/sulfamethoxazole. Over the study period, bacteraemia secondary to these strains alone, added over $9 million to costs for healthcare in the Calgary Zone.
我们评估了成人中敏感和耐药血流感染（BSI）的成本。次要结果是BSI对住院时间（LOS）、再入院率和死亡率的影响。
我们研究了2011年至2018年加拿大卡尔加里基于人群的血培养回顾性队列，并将其与微观成本核算和总成本核算数据相关联。完成倾向得分匹配后，使用线性回归比较了90天内无BSI和有BSI患者之间的成本。
在研究期间，89673名成人中共有4581例BSI发生菌血症。成人90天内BSI的平均成本为39072美元（标准差：95747美元）。与敏感BSI相比，对头孢曲松耐药（CRO-R）、对氟喹诺酮类（FQ）和甲氧苄啶/磺胺甲恶唑耐药的BSI导致的平均成本最高，为53899美元，再入院几率、住院时间增加和死亡几率也最高。
BSI与高昂成本相关。对CRO-R且对FQ和甲氧苄啶/磺胺甲恶唑耐药的患者，总成本差异最大。在研究期间，仅由这些菌株引起的菌血症就使卡尔加里地区的医疗保健成本增加了900多万美元。
