Cargando…

The health and economic burden of bloodstream infections caused by antimicrobial-susceptible and non-susceptible Enterobacteriaceae and Staphylococcus aureus in European hospitals, 2010 and 2011: a multicentre retrospective cohort study

We performed a multicentre retrospective cohort study including 606,649 acute inpatient episodes at 10 European hospitals in 2010 and 2011 to estimate the impact of antimicrobial resistance on hospital mortality, excess length of stay (LOS) and cost. Bloodstream infections (BSI) caused by third-gene...

Descripción completa

Detalles Bibliográficos
Autores principales: Stewardson, Andrew J, Allignol, Arthur, Beyersmann, Jan, Graves, Nicholas, Schumacher, Martin, Meyer, Rodolphe, Tacconelli, Evelina, De Angelis, Giulia, Farina, Claudio, Pezzoli, Fabio, Bertrand, Xavier, Gbaguidi-Haore, Houssein, Edgeworth, Jonathan, Tosas, Olga, Martinez, Jose A, Ayala-Blanco, M Pilar, Pan, Angelo, Zoncada, Alessia, Marwick, Charis A, Nathwani, Dilip, Seifert, Harald, Hos, Nina, Hagel, Stefan, Pletz, Mathias, Harbarth, Stephan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: European Centre for Disease Prevention and Control (ECDC) 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4998424/
https://www.ncbi.nlm.nih.gov/pubmed/27562950
http://dx.doi.org/10.2807/1560-7917.ES.2016.21.33.30319
_version_ 1782449939615318016
author Stewardson, Andrew J
Allignol, Arthur
Beyersmann, Jan
Graves, Nicholas
Schumacher, Martin
Meyer, Rodolphe
Tacconelli, Evelina
De Angelis, Giulia
Farina, Claudio
Pezzoli, Fabio
Bertrand, Xavier
Gbaguidi-Haore, Houssein
Edgeworth, Jonathan
Tosas, Olga
Martinez, Jose A
Ayala-Blanco, M Pilar
Pan, Angelo
Zoncada, Alessia
Marwick, Charis A
Nathwani, Dilip
Seifert, Harald
Hos, Nina
Hagel, Stefan
Pletz, Mathias
Harbarth, Stephan
author_facet Stewardson, Andrew J
Allignol, Arthur
Beyersmann, Jan
Graves, Nicholas
Schumacher, Martin
Meyer, Rodolphe
Tacconelli, Evelina
De Angelis, Giulia
Farina, Claudio
Pezzoli, Fabio
Bertrand, Xavier
Gbaguidi-Haore, Houssein
Edgeworth, Jonathan
Tosas, Olga
Martinez, Jose A
Ayala-Blanco, M Pilar
Pan, Angelo
Zoncada, Alessia
Marwick, Charis A
Nathwani, Dilip
Seifert, Harald
Hos, Nina
Hagel, Stefan
Pletz, Mathias
Harbarth, Stephan
author_sort Stewardson, Andrew J
collection PubMed
description We performed a multicentre retrospective cohort study including 606,649 acute inpatient episodes at 10 European hospitals in 2010 and 2011 to estimate the impact of antimicrobial resistance on hospital mortality, excess length of stay (LOS) and cost. Bloodstream infections (BSI) caused by third-generation cephalosporin-resistant Enterobacteriaceae (3GCRE), meticillin-susceptible (MSSA) and -resistant Staphylococcus aureus (MRSA) increased the daily risk of hospital death (adjusted hazard ratio (HR) = 1.80; 95% confidence interval (CI): 1.34–2.42, HR = 1.81; 95% CI: 1.49–2.20 and HR = 2.42; 95% CI: 1.66–3.51, respectively) and prolonged LOS (9.3 days; 95% CI: 9.2–9.4, 11.5 days; 95% CI: 11.5–11.6 and 13.3 days; 95% CI: 13.2–13.4, respectively). BSI with third-generation cephalosporin-susceptible Enterobacteriaceae (3GCSE) significantly increased LOS (5.9 days; 95% CI: 5.8–5.9) but not hazard of death (1.16; 95% CI: 0.98–1.36). 3GCRE significantly increased the hazard of death (1.63; 95% CI: 1.13–2.35), excess LOS (4.9 days; 95% CI: 1.1–8.7) and cost compared with susceptible strains, whereas meticillin resistance did not. The annual cost of 3GCRE BSI was higher than of MRSA BSI. While BSI with S. aureus had greater impact on mortality, excess LOS and cost than Enterobacteriaceae per infection, the impact of antimicrobial resistance was greater for Enterobacteriaceae.
format Online
Article
Text
id pubmed-4998424
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher European Centre for Disease Prevention and Control (ECDC)
record_format MEDLINE/PubMed
spelling pubmed-49984242016-09-28 The health and economic burden of bloodstream infections caused by antimicrobial-susceptible and non-susceptible Enterobacteriaceae and Staphylococcus aureus in European hospitals, 2010 and 2011: a multicentre retrospective cohort study Stewardson, Andrew J Allignol, Arthur Beyersmann, Jan Graves, Nicholas Schumacher, Martin Meyer, Rodolphe Tacconelli, Evelina De Angelis, Giulia Farina, Claudio Pezzoli, Fabio Bertrand, Xavier Gbaguidi-Haore, Houssein Edgeworth, Jonathan Tosas, Olga Martinez, Jose A Ayala-Blanco, M Pilar Pan, Angelo Zoncada, Alessia Marwick, Charis A Nathwani, Dilip Seifert, Harald Hos, Nina Hagel, Stefan Pletz, Mathias Harbarth, Stephan Euro Surveill Research Article We performed a multicentre retrospective cohort study including 606,649 acute inpatient episodes at 10 European hospitals in 2010 and 2011 to estimate the impact of antimicrobial resistance on hospital mortality, excess length of stay (LOS) and cost. Bloodstream infections (BSI) caused by third-generation cephalosporin-resistant Enterobacteriaceae (3GCRE), meticillin-susceptible (MSSA) and -resistant Staphylococcus aureus (MRSA) increased the daily risk of hospital death (adjusted hazard ratio (HR) = 1.80; 95% confidence interval (CI): 1.34–2.42, HR = 1.81; 95% CI: 1.49–2.20 and HR = 2.42; 95% CI: 1.66–3.51, respectively) and prolonged LOS (9.3 days; 95% CI: 9.2–9.4, 11.5 days; 95% CI: 11.5–11.6 and 13.3 days; 95% CI: 13.2–13.4, respectively). BSI with third-generation cephalosporin-susceptible Enterobacteriaceae (3GCSE) significantly increased LOS (5.9 days; 95% CI: 5.8–5.9) but not hazard of death (1.16; 95% CI: 0.98–1.36). 3GCRE significantly increased the hazard of death (1.63; 95% CI: 1.13–2.35), excess LOS (4.9 days; 95% CI: 1.1–8.7) and cost compared with susceptible strains, whereas meticillin resistance did not. The annual cost of 3GCRE BSI was higher than of MRSA BSI. While BSI with S. aureus had greater impact on mortality, excess LOS and cost than Enterobacteriaceae per infection, the impact of antimicrobial resistance was greater for Enterobacteriaceae. European Centre for Disease Prevention and Control (ECDC) 2016-08-18 /pmc/articles/PMC4998424/ /pubmed/27562950 http://dx.doi.org/10.2807/1560-7917.ES.2016.21.33.30319 Text en This article is copyright of The Authors, 2016. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution (CC BY 4.0) Licence. You may share and adapt the material, but must give appropriate credit to the source, provide a link to the licence, and indicate if changes were made.
spellingShingle Research Article
Stewardson, Andrew J
Allignol, Arthur
Beyersmann, Jan
Graves, Nicholas
Schumacher, Martin
Meyer, Rodolphe
Tacconelli, Evelina
De Angelis, Giulia
Farina, Claudio
Pezzoli, Fabio
Bertrand, Xavier
Gbaguidi-Haore, Houssein
Edgeworth, Jonathan
Tosas, Olga
Martinez, Jose A
Ayala-Blanco, M Pilar
Pan, Angelo
Zoncada, Alessia
Marwick, Charis A
Nathwani, Dilip
Seifert, Harald
Hos, Nina
Hagel, Stefan
Pletz, Mathias
Harbarth, Stephan
The health and economic burden of bloodstream infections caused by antimicrobial-susceptible and non-susceptible Enterobacteriaceae and Staphylococcus aureus in European hospitals, 2010 and 2011: a multicentre retrospective cohort study
title The health and economic burden of bloodstream infections caused by antimicrobial-susceptible and non-susceptible Enterobacteriaceae and Staphylococcus aureus in European hospitals, 2010 and 2011: a multicentre retrospective cohort study
title_full The health and economic burden of bloodstream infections caused by antimicrobial-susceptible and non-susceptible Enterobacteriaceae and Staphylococcus aureus in European hospitals, 2010 and 2011: a multicentre retrospective cohort study
title_fullStr The health and economic burden of bloodstream infections caused by antimicrobial-susceptible and non-susceptible Enterobacteriaceae and Staphylococcus aureus in European hospitals, 2010 and 2011: a multicentre retrospective cohort study
title_full_unstemmed The health and economic burden of bloodstream infections caused by antimicrobial-susceptible and non-susceptible Enterobacteriaceae and Staphylococcus aureus in European hospitals, 2010 and 2011: a multicentre retrospective cohort study
title_short The health and economic burden of bloodstream infections caused by antimicrobial-susceptible and non-susceptible Enterobacteriaceae and Staphylococcus aureus in European hospitals, 2010 and 2011: a multicentre retrospective cohort study
title_sort health and economic burden of bloodstream infections caused by antimicrobial-susceptible and non-susceptible enterobacteriaceae and staphylococcus aureus in european hospitals, 2010 and 2011: a multicentre retrospective cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4998424/
https://www.ncbi.nlm.nih.gov/pubmed/27562950
http://dx.doi.org/10.2807/1560-7917.ES.2016.21.33.30319
work_keys_str_mv AT stewardsonandrewj thehealthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT allignolarthur thehealthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT beyersmannjan thehealthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT gravesnicholas thehealthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT schumachermartin thehealthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT meyerrodolphe thehealthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT tacconellievelina thehealthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT deangelisgiulia thehealthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT farinaclaudio thehealthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT pezzolifabio thehealthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT bertrandxavier thehealthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT gbaguidihaorehoussein thehealthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT edgeworthjonathan thehealthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT tosasolga thehealthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT martinezjosea thehealthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT ayalablancompilar thehealthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT panangelo thehealthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT zoncadaalessia thehealthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT marwickcharisa thehealthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT nathwanidilip thehealthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT seifertharald thehealthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT hosnina thehealthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT hagelstefan thehealthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT pletzmathias thehealthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT harbarthstephan thehealthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT thehealthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT stewardsonandrewj healthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT allignolarthur healthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT beyersmannjan healthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT gravesnicholas healthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT schumachermartin healthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT meyerrodolphe healthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT tacconellievelina healthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT deangelisgiulia healthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT farinaclaudio healthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT pezzolifabio healthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT bertrandxavier healthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT gbaguidihaorehoussein healthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT edgeworthjonathan healthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT tosasolga healthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT martinezjosea healthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT ayalablancompilar healthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT panangelo healthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT zoncadaalessia healthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT marwickcharisa healthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT nathwanidilip healthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT seifertharald healthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT hosnina healthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT hagelstefan healthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT pletzmathias healthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT harbarthstephan healthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy
AT healthandeconomicburdenofbloodstreaminfectionscausedbyantimicrobialsusceptibleandnonsusceptibleenterobacteriaceaeandstaphylococcusaureusineuropeanhospitals2010and2011amulticentreretrospectivecohortstudy