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Incremental clinical and economic burden of suspected respiratory infections due to multi-drug-resistant Pseudomonas aeruginosa in the United States

2019; Elsevier BV; Volume: 103; Issue: 2 Linguagem: Inglês

10.1016/j.jhin.2019.06.005

1532-2939

Ying P. Tabak, Sanjay Merchant, G. Ye, Latha Vankeepuram, Vikas Gupta, Steven Kurtz, Laura Puzniak,

Pneumonia and Respiratory Infections

Multi-drug resistant (MDR) Pseudomonas aeruginosa can negatively affect patients and hospitals.To evaluate excess mortality and cost burden among patients hospitalized with suspected respiratory infections due to MDR P. aeruginosa vs patients with non-MDR P. aeruginosa in 78 United States (US) hospitals.This study analyzed electronically captured microbiological and outcomes data of patients hospitalized with non-duplicate P. aeruginosa isolates from respiratory sources collected ≥3 days after admission to identify hospital-onset MDR or non-MDR P. aeruginosa per the Centers for Disease Control and Prevention definition. The risk of multi-drug resistance was estimated on mortality, length of stay (LOS), cost, operation gain/loss, and 30-day readmission. A sensitivity analysis was conducted utilizing a cohort with pharmacy data available.Of 523 MDR and 1381 non-MDR P. aeruginosa cases, unadjusted mortality was 23.7% vs 18.0% and multi-variable-adjusted mortality was 20.0% (95% confidence interval (CI): 14.3-27.2%) vs 15.5% (95% CI: 11.2-20.9%; P=0.026), the average adjusted excess LOS was 6.7 days (P US$10,000 incremental net loss per case after controlling for patient and hospital characteristics.