University Library
  • Login
A gateway to Melbourne's research publications
Minerva Access is the University's Institutional Repository. It aims to collect, preserve, and showcase the intellectual output of staff and students of the University of Melbourne for a global audience.
View Item 
  • Minerva Access
  • Medicine, Dentistry & Health Sciences
  • Melbourne Medical School
  • Medical Education
  • Medical Education - Research Publications
  • View Item
  • Minerva Access
  • Medicine, Dentistry & Health Sciences
  • Melbourne Medical School
  • Medical Education
  • Medical Education - Research Publications
  • View Item
JavaScript is disabled for your browser. Some features of this site may not work without it.

    Attributable length of stay, mortality risk and costs of bacterial healthcare-associated infections in Australia: a retrospective case-cohort study.

    Thumbnail
    Download
    Published version (511.0Kb)

    Citations
    Altmetric
    Author
    Lee, XJ; Stewardson, AJ; Worth, LJ; Graves, N; Wozniak, TM
    Date
    2020-08-21
    Source Title
    Clinical Infectious Diseases
    Publisher
    Oxford University Press (OUP)
    University of Melbourne Author/s
    Worth, Leon
    Affiliation
    Medical Education
    Metadata
    Show full item record
    Document Type
    Journal Article
    Citations
    Lee, X. J., Stewardson, A. J., Worth, L. J., Graves, N. & Wozniak, T. M. (2020). Attributable length of stay, mortality risk and costs of bacterial healthcare-associated infections in Australia: a retrospective case-cohort study.. Clin Infect Dis, pp.ciaa1228--. https://doi.org/10.1093/cid/ciaa1228.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/252544
    DOI
    10.1093/cid/ciaa1228
    Abstract
    BACKGROUND: Unbiased estimates of the health and economic impact of healthcare-associated infections (HAIs) are scarce and focus largely on patients with bloodstream infection (BSI). We sought to estimate the hospital length of stay (LOS), mortality and costs of HAIs and the differential effect on patients with an antimicrobial resistance (AMR) infection. METHODS: A multi-site, retrospective case-cohort of all acute-care hospital admissions with a positive culture of one of the five organisms of interest (Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphylococcus aureus or Enterococcus faecium) from January 1, 2012 through December 30, 2016. Data linkage was used to generate a dataset of statewide hospital admissions and pathology data. Patients with bloodstream, urinary or respiratory tract infections were included in the analysis and matched to a sample of uninfected patients. We use multistate survival models to generate LOS and logistic regression to derive mortality estimates. RESULTS: 20,390 cases were matched to 75,635 uninfected control patients. The overall incidence of infections due to the five studied organisms was 116.9 cases per 100,000 patient days with E. coli urinary tract infections (UTI)s contributing the largest proportion (51 cases per 100 000 patient days). The impact of a UTI on hospital stay was moderate across the five studied pathogens. Resistance significantly increased hospital stay for patients with third-generation cephalosporin-resistant K. pneumoniae bloodstream infection (BSI) (extra 4.6 days) and methicillin-resistant S. aureus (MRSA) BSI (extra 2.9 days). Consequently, healthcare costs of these infections were higher, compared to corresponding drug-sensitive strains. CONCLUSIONS: The health burden remains highest for BSIs, however the UTIs and respiratory tract infections (RTI) contributed most to the healthcare system expenditure.

    Export Reference in RIS Format     

    Endnote

    • Click on "Export Reference in RIS Format" and choose "open with... Endnote".

    Refworks

    • Click on "Export Reference in RIS Format". Login to Refworks, go to References => Import References


    Collections
    • Minerva Elements Records [52443]
    • Medical Education - Research Publications [594]
    Minerva AccessDepositing Your Work (for University of Melbourne Staff and Students)NewsFAQs

    BrowseCommunities & CollectionsBy Issue DateAuthorsTitlesSubjectsThis CollectionBy Issue DateAuthorsTitlesSubjects
    My AccountLoginRegister
    StatisticsMost Popular ItemsStatistics by CountryMost Popular Authors