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dc.contributor.authorLee, XJ
dc.contributor.authorStewardson, AJ
dc.contributor.authorWorth, LJ
dc.contributor.authorGraves, N
dc.contributor.authorWozniak, TM
dc.date.accessioned2020-11-27T00:39:52Z
dc.date.available2020-11-27T00:39:52Z
dc.date.issued2021-05-15
dc.identifierpii: 5895480
dc.identifier.citationLee, X. J., Stewardson, A. J., Worth, L. J., Graves, N. & Wozniak, T. M. (2021). Attributable Length of Stay, Mortality Risk, and Costs of Bacterial Health Care-Associated Infections in Australia: A Retrospective Case-cohort Study. CLINICAL INFECTIOUS DISEASES, 72 (10), pp.E506-E514. https://doi.org/10.1093/cid/ciaa1228.
dc.identifier.issn1058-4838
dc.identifier.urihttp://hdl.handle.net/11343/252544
dc.description.abstractBACKGROUND: Unbiased estimates of the health and economic impacts of health care-associated infections (HAIs) are scarce and focus largely on patients with bloodstream infections (BSIs). We sought to estimate the hospital length of stay (LOS), mortality rate, and costs of HAIs and the differential effects on patients with an antimicrobial-resistant infection. METHODS: We conducted a multisite, retrospective case-cohort of all acute-care hospital admissions with a positive culture of 1 of the 5 organisms of interest (Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphylococcus aureus, or Enterococcus faecium) from 1 January 2012 through 30 December 2016. Data linkage was used to generate a data set 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 used multistate survival models to generate LOS, and logistic regression to derive mortality estimates. RESULTS: We matched 20 390 cases to 75 635 uninfected control patients. The overall incidence of infections due to the 5 studied organisms was 116.9 cases per 100 000 patient days, with E. coli urinary tract infections (UTIs) contributing the largest proportion (51 cases per 100 000 patient days). The impact of a UTI on LOS was moderate across the 5 studied pathogens. Resistance significantly increased LOS for patients with third-generation cephalosporin-resistant K. pneumoniae BSIs (extra 4.6 days) and methicillin-resistant S. aureus BSIs (extra 2.9 days). Consequently, the health-care costs of these infections were higher, compared to corresponding drug-sensitive strains. CONCLUSIONS: The health burden remains highest for BSIs; however, UTIs and respiratory tract infections contributed most to the health-care system expenditure.
dc.languageEnglish
dc.publisherOXFORD UNIV PRESS INC
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0
dc.titleAttributable Length of Stay, Mortality Risk, and Costs of Bacterial Health Care-Associated Infections in Australia: A Retrospective Case-cohort Study
dc.typeJournal Article
dc.identifier.doi10.1093/cid/ciaa1228
melbourne.affiliation.departmentMedical Education
melbourne.source.titleClinical Infectious Diseases
melbourne.source.volume72
melbourne.source.issue10
melbourne.source.pagesE506-E514
melbourne.identifier.nhmrc1116530
dc.rights.licenseCC BY-NC-ND
melbourne.elementsid1463413
melbourne.openaccess.pmchttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC8130032
melbourne.contributor.authorWorth, Leon
dc.identifier.eissn1537-6591
melbourne.identifier.fundernameidNHMRC, 1116530
melbourne.accessrightsOpen Access


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