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The Clinical and Economic Impact of Antibiotic Resistance in China: A Systematic Review and Meta-Analysis

Antibiotic resistance (ABR) is one of the biggest threats to global health, especially in China. This study aims to analyze the published literature on the clinical and economic impact of ABR or multi-drug resistant (MDR) bacteria compared to susceptible bacteria or non-infection, in mainland China....

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Autores principales: Zhen, Xuemei, Stålsby Lundborg, Cecilia, Sun, Xueshan, Hu, Xiaoqian, Dong, Hengjin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6784351/
https://www.ncbi.nlm.nih.gov/pubmed/31405146
http://dx.doi.org/10.3390/antibiotics8030115
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author Zhen, Xuemei
Stålsby Lundborg, Cecilia
Sun, Xueshan
Hu, Xiaoqian
Dong, Hengjin
author_facet Zhen, Xuemei
Stålsby Lundborg, Cecilia
Sun, Xueshan
Hu, Xiaoqian
Dong, Hengjin
author_sort Zhen, Xuemei
collection PubMed
description Antibiotic resistance (ABR) is one of the biggest threats to global health, especially in China. This study aims to analyze the published literature on the clinical and economic impact of ABR or multi-drug resistant (MDR) bacteria compared to susceptible bacteria or non-infection, in mainland China. English and Chinese databases were searched to identify relevant studies evaluating mortality, hospital stay, and hospital costs of ABR. A meta-analysis of mortality was performed using a random effects model. The costs were converted into 2015 United States (US) dollars. Of 13,693 studies identified, 44 eligible studies were included. Twenty-nine investigated the impact of ABR on hospital mortality, 37 were focused on hospital stay, and 21 on hospital costs. Patients with ABR were associated with a greater risk of overall mortality compared to those with susceptibility or those without infection (odds ratio: 2.67 and 3.29, 95% confidence interval: 2.18–3.26 and 1.71–6.33, p < 0.001 and p < 0.001, respectively). The extra mean total hospital stay and total hospital cost were reported, ranging from 3 to 46 days, and from US$238 to US$16,496, respectively. Our study indicates that ABR is associated with significantly higher mortality. Moreover, ABR is not always, but usually, associated with significantly longer hospital stay and higher hospital costs.
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spelling pubmed-67843512019-10-16 The Clinical and Economic Impact of Antibiotic Resistance in China: A Systematic Review and Meta-Analysis Zhen, Xuemei Stålsby Lundborg, Cecilia Sun, Xueshan Hu, Xiaoqian Dong, Hengjin Antibiotics (Basel) Review Antibiotic resistance (ABR) is one of the biggest threats to global health, especially in China. This study aims to analyze the published literature on the clinical and economic impact of ABR or multi-drug resistant (MDR) bacteria compared to susceptible bacteria or non-infection, in mainland China. English and Chinese databases were searched to identify relevant studies evaluating mortality, hospital stay, and hospital costs of ABR. A meta-analysis of mortality was performed using a random effects model. The costs were converted into 2015 United States (US) dollars. Of 13,693 studies identified, 44 eligible studies were included. Twenty-nine investigated the impact of ABR on hospital mortality, 37 were focused on hospital stay, and 21 on hospital costs. Patients with ABR were associated with a greater risk of overall mortality compared to those with susceptibility or those without infection (odds ratio: 2.67 and 3.29, 95% confidence interval: 2.18–3.26 and 1.71–6.33, p < 0.001 and p < 0.001, respectively). The extra mean total hospital stay and total hospital cost were reported, ranging from 3 to 46 days, and from US$238 to US$16,496, respectively. Our study indicates that ABR is associated with significantly higher mortality. Moreover, ABR is not always, but usually, associated with significantly longer hospital stay and higher hospital costs. MDPI 2019-08-10 /pmc/articles/PMC6784351/ /pubmed/31405146 http://dx.doi.org/10.3390/antibiotics8030115 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Zhen, Xuemei
Stålsby Lundborg, Cecilia
Sun, Xueshan
Hu, Xiaoqian
Dong, Hengjin
The Clinical and Economic Impact of Antibiotic Resistance in China: A Systematic Review and Meta-Analysis
title The Clinical and Economic Impact of Antibiotic Resistance in China: A Systematic Review and Meta-Analysis
title_full The Clinical and Economic Impact of Antibiotic Resistance in China: A Systematic Review and Meta-Analysis
title_fullStr The Clinical and Economic Impact of Antibiotic Resistance in China: A Systematic Review and Meta-Analysis
title_full_unstemmed The Clinical and Economic Impact of Antibiotic Resistance in China: A Systematic Review and Meta-Analysis
title_short The Clinical and Economic Impact of Antibiotic Resistance in China: A Systematic Review and Meta-Analysis
title_sort clinical and economic impact of antibiotic resistance in china: a systematic review and meta-analysis
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6784351/
https://www.ncbi.nlm.nih.gov/pubmed/31405146
http://dx.doi.org/10.3390/antibiotics8030115
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