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779. Clostridiodes difficile: Is it time for surveillance! Cost-benefit analysis

BACKGROUND: Clostridiodes difficile infection (CDI) has substantial morbidity, mortality and expense. Hospital surveillance to detect CD carriers could affect antibiotic use and determination of community-associated vs hospital-associated CDI. METHODS: A decision tree examined the cost-effectiveness...

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Autores principales: Yassin, Mohamed, Donskey, Curtis, Arbulu, Ricardo, Dixon, Heather, Smith, Kenneth
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7777976/
http://dx.doi.org/10.1093/ofid/ofaa439.969
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author Yassin, Mohamed
Donskey, Curtis
Arbulu, Ricardo
Dixon, Heather
Smith, Kenneth
author_facet Yassin, Mohamed
Donskey, Curtis
Arbulu, Ricardo
Dixon, Heather
Smith, Kenneth
author_sort Yassin, Mohamed
collection PubMed
description BACKGROUND: Clostridiodes difficile infection (CDI) has substantial morbidity, mortality and expense. Hospital surveillance to detect CD carriers could affect antibiotic use and determination of community-associated vs hospital-associated CDI. METHODS: A decision tree examined the cost-effectiveness of hospital CD surveillance compared to current practice (testing as indicated). Costs for CD testing, community-associated CDI and hospital-associated CDI came from US databases. CD carrier and infection probabilities came from literature and local data. Analyses examined potential benefits from 1) knowledge of CD carrier status affecting antibiotic use (healthcare perspective) and 2) avoiding penalties for hospital-acquired CDI (hospital perspective). RESULTS: From the healthcare perspective, if antibiotic use is unchanged by CD status, surveillance costs $39/patient than current practice with unchanged CDI risk. However, if knowing CD status changed antibiotic prescribing such that CDI risk decreased by 10% or 20%, then cost/CDI avoided becomes $15,519 and $3,822 respectively, with CD surveillance becoming cheaper and more effective current practice if CDI risk decreased ≥30%. From the hospital perspective, using published CDI incidence (2.7%) and a hospital-associated CDI penalty of $30,000, surveillance cost $336/patient less than current practice if patients colonized on admission were not considered hospital-associated CDI and $476/patient less with local data (incidence 4.2%). CONCLUSION: Hospital CD surveillance is potentially a cost-effective or cost-saving strategy depending on perspective taken and clinical usage of these data. This strategy could be implemented hospital-wide or in high-risk populations. CD surveillance could be both cost-saving and decrease CDI risk if more appropriate antibiotic use results from its use. DISCLOSURES: All Authors: No reported disclosures
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spelling pubmed-77779762021-01-07 779. Clostridiodes difficile: Is it time for surveillance! Cost-benefit analysis Yassin, Mohamed Donskey, Curtis Arbulu, Ricardo Dixon, Heather Smith, Kenneth Open Forum Infect Dis Poster Abstracts BACKGROUND: Clostridiodes difficile infection (CDI) has substantial morbidity, mortality and expense. Hospital surveillance to detect CD carriers could affect antibiotic use and determination of community-associated vs hospital-associated CDI. METHODS: A decision tree examined the cost-effectiveness of hospital CD surveillance compared to current practice (testing as indicated). Costs for CD testing, community-associated CDI and hospital-associated CDI came from US databases. CD carrier and infection probabilities came from literature and local data. Analyses examined potential benefits from 1) knowledge of CD carrier status affecting antibiotic use (healthcare perspective) and 2) avoiding penalties for hospital-acquired CDI (hospital perspective). RESULTS: From the healthcare perspective, if antibiotic use is unchanged by CD status, surveillance costs $39/patient than current practice with unchanged CDI risk. However, if knowing CD status changed antibiotic prescribing such that CDI risk decreased by 10% or 20%, then cost/CDI avoided becomes $15,519 and $3,822 respectively, with CD surveillance becoming cheaper and more effective current practice if CDI risk decreased ≥30%. From the hospital perspective, using published CDI incidence (2.7%) and a hospital-associated CDI penalty of $30,000, surveillance cost $336/patient less than current practice if patients colonized on admission were not considered hospital-associated CDI and $476/patient less with local data (incidence 4.2%). CONCLUSION: Hospital CD surveillance is potentially a cost-effective or cost-saving strategy depending on perspective taken and clinical usage of these data. This strategy could be implemented hospital-wide or in high-risk populations. CD surveillance could be both cost-saving and decrease CDI risk if more appropriate antibiotic use results from its use. DISCLOSURES: All Authors: No reported disclosures Oxford University Press 2020-12-31 /pmc/articles/PMC7777976/ http://dx.doi.org/10.1093/ofid/ofaa439.969 Text en © The Author 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Poster Abstracts
Yassin, Mohamed
Donskey, Curtis
Arbulu, Ricardo
Dixon, Heather
Smith, Kenneth
779. Clostridiodes difficile: Is it time for surveillance! Cost-benefit analysis
title 779. Clostridiodes difficile: Is it time for surveillance! Cost-benefit analysis
title_full 779. Clostridiodes difficile: Is it time for surveillance! Cost-benefit analysis
title_fullStr 779. Clostridiodes difficile: Is it time for surveillance! Cost-benefit analysis
title_full_unstemmed 779. Clostridiodes difficile: Is it time for surveillance! Cost-benefit analysis
title_short 779. Clostridiodes difficile: Is it time for surveillance! Cost-benefit analysis
title_sort 779. clostridiodes difficile: is it time for surveillance! cost-benefit analysis
topic Poster Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7777976/
http://dx.doi.org/10.1093/ofid/ofaa439.969
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