Abstract:
: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.
journal_name
Euro Surveilljournal_title
Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletinauthors
Stewardson AJ,Allignol A,Beyersmann J,Graves N,Schumacher M,Meyer R,Tacconelli E,De Angelis G,Farina C,Pezzoli F,Bertrand X,Gbaguidi-Haore H,Edgeworth J,Tosas O,Martinez JA,Ayala-Blanco MP,Pan A,Zoncada A,Marwick CA,doi
10.2807/1560-7917.ES.2016.21.33.30319subject
Has Abstractpub_date
2016-08-18 00:00:00issue
33eissn
1025-496Xissn
1560-7917pii
30319journal_volume
21pub_type
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