Zhihui Chen1, Ziqin Xu2, Hongmei Wu2, Le Chen2, Shengchun Gao2, Yangfang Chen3. 1. Department of Infection Control, Wenzhou People's Hospital, Wenzhou, China. Electronic address: czhdemail@126.com. 2. Department of Infection Control, Wenzhou People's Hospital, Wenzhou, China. 3. Laboratory of Microbiology, Wenzhou People's Hospital, Wenzhou, China.
Abstract
BACKGROUND: This study aimed to estimate the impact of carbapenem-resistant Pseudomonas aeruginosa (CRPA) on clinical and economic outcomes in a Chinese tertiary care hospital. METHODS: Patients were assigned to a carbapenem-susceptible P aeruginosa group or to a CRPA group and matched using propensity score matching. In-hospital mortality, length of stay (LOS), LOS after culture, total hospital costs, daily hospital cost, and 30-day readmission were comparatively analyzed. Subgroup analysis was performed to determine the associations between the subgrouping factors and in-hospital mortality in patients with CRPA isolates. RESULTS: Within the propensity-matched cohort, in-hospital mortality (12.6% vs 7.8%; P = .044), LOS (median 29.0 vs 25.5 days; P = .026), LOS after culture (median 18.5 vs 14.0 days; P = .029), total hospital costs (median $6,082.0 vs $4,954.2; P = .015), and daily hospital cost (median $236.1 vs $223.6; P = .045) were significantly higher in CRPA patients than in carbapenem-susceptible P aeruginosa patients. Subgroup analysis revealed a significant interaction between CRPA and age (P = .009). CONCLUSION: Prevention and control of CRPA among hospitalized patients, especially among those over the age of 65 years, is a good measurement for the reduction of mortality and medical costs derived from CRPA infection or colonization.
BACKGROUND: This study aimed to estimate the impact of carbapenem-resistant Pseudomonas aeruginosa (CRPA) on clinical and economic outcomes in a Chinese tertiary care hospital. METHODS:Patients were assigned to a carbapenem-susceptible P aeruginosa group or to a CRPA group and matched using propensity score matching. In-hospital mortality, length of stay (LOS), LOS after culture, total hospital costs, daily hospital cost, and 30-day readmission were comparatively analyzed. Subgroup analysis was performed to determine the associations between the subgrouping factors and in-hospital mortality in patients with CRPA isolates. RESULTS: Within the propensity-matched cohort, in-hospital mortality (12.6% vs 7.8%; P = .044), LOS (median 29.0 vs 25.5 days; P = .026), LOS after culture (median 18.5 vs 14.0 days; P = .029), total hospital costs (median $6,082.0 vs $4,954.2; P = .015), and daily hospital cost (median $236.1 vs $223.6; P = .045) were significantly higher in CRPA patients than in carbapenem-susceptible P aeruginosapatients. Subgroup analysis revealed a significant interaction between CRPA and age (P = .009). CONCLUSION: Prevention and control of CRPA among hospitalized patients, especially among those over the age of 65 years, is a good measurement for the reduction of mortality and medical costs derived from CRPA infection or colonization.
Authors: Miquel Serra-Burriel; Matthew Keys; Carlos Campillo-Artero; Antonella Agodi; Martina Barchitta; Achilleas Gikas; Carlos Palos; Guillem López-Casasnovas Journal: PLoS One Date: 2020-01-10 Impact factor: 3.240