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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...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
European Centre for Disease Prevention and Control (ECDC)
2016
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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 |
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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 |
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