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Clinical and economic burden of community-onset multidrug-resistant infections requiring hospitalization.
López-Montesinos, I; Domínguez-Guasch, A; Gómez-Zorrilla, S; Duran-Jordà, X; Siverio-Parès, A; Arenas-Miras, M M; Montero, M M; Sorli Redó, L; Grau, S; Horcajada, J P.
Afiliación
  • López-Montesinos I; Infectious Diseases Service, Hospital del Mar, Infectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona (UAB), CEXS-Universitat Pompeu Fabra, Spanish Network for Research in Infectious Diseases (REIPI
  • Domínguez-Guasch A; CEXS-Universitat Pompeu Fabra, Barcelona, Spain.
  • Gómez-Zorrilla S; Infectious Diseases Service, Hospital del Mar, Infectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona (UAB), CEXS-Universitat Pompeu Fabra, Spanish Network for Research in Infectious Diseases (REIPI
  • Duran-Jordà X; Methodology and Biostatistics Support Unit, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain.
  • Siverio-Parès A; Microbiology Service, Laboratori de Referència de Catalunya, Hospital del Mar, Barcelona, Spain.
  • Arenas-Miras MM; Infectious Diseases Service, Hospital del Mar, Infectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona (UAB), CEXS-Universitat Pompeu Fabra, Spanish Network for Research in Infectious Diseases (REIPI
  • Montero MM; Infectious Diseases Service, Hospital del Mar, Infectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona (UAB), CEXS-Universitat Pompeu Fabra, Spanish Network for Research in Infectious Diseases (REIPI
  • Sorli Redó L; Infectious Diseases Service, Hospital del Mar, Infectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona (UAB), CEXS-Universitat Pompeu Fabra, Spanish Network for Research in Infectious Diseases (REIPI
  • Grau S; Pharmacy Service, Hospital del Mar, Infectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona (UAB), CEXS-Universitat Pompeu Fabra, Barcelona, Spain.
  • Horcajada JP; Infectious Diseases Service, Hospital del Mar, Infectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona (UAB), CEXS-Universitat Pompeu Fabra, Spanish Network for Research in Infectious Diseases (REIPI
J Infect ; 80(3): 271-278, 2020 03.
Article en En | MEDLINE | ID: mdl-31917968
OBJECTIVES: To analyze the clinical and economic burden of community-acquired (CA) or community-onset healthcare-associated (COHCA) multidrug-resistant (MDR) infections requiring hospitalization. METHODS: Case-control study. Adults admitted with CA or COHCA MDR infections were considered cases, while those admitted in the same period with non-MDR infections were controls. The matching criteria were source of infection and/or microorganism. Primary outcome was 30-day clinical failure. Secondary outcomes were 90-day and 1-year mortality, hospitalization costs and resource consumption. RESULTS: 194 patients (97 cases and 97 controls) were included. Multivariate analysis identified age (odds ratio [OR], 1.07, 95% confidence interval [CI], 1.01-1.14) and SOFA score (OR, 1.45, CI95%, 1.15-1.84) as independent predictors of 30-day clinical failure. Age (hazard ratio [HR] 1.09, 95%CI, 1.03-1.16) was the only factor associated with 90-day mortality, whereas age (HR 1.06, 95%CI, 1.03-1.09) and Charlson Index (HR 1.2, 95%CI, 1.07-1.34) were associated with 1-year mortality. MDR group showed longer hospitalization (p<0.001) and MDR hospitalization costs almost doubled those in the non-MDR group. MDR infections were associated with higher antimicrobial costs. CONCLUSIONS: Worse economic outcomes were identified with community-onset MDR infections. MDR was associated with worse clinical outcomes but mainly due to higher comorbidity of patients in MDR group, rather than multidrug resistance.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infección Hospitalaria / Costo de Enfermedad Tipo de estudio: Etiology_studies / Health_economic_evaluation / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Humans Idioma: En Revista: J Infect Año: 2020 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infección Hospitalaria / Costo de Enfermedad Tipo de estudio: Etiology_studies / Health_economic_evaluation / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Humans Idioma: En Revista: J Infect Año: 2020 Tipo del documento: Article Pais de publicación: Reino Unido