Clinical and economic impact of meropenem resistance in Pseudomonas aeruginosa–infected patients

Judd, William R.; Ratliff, Patrick D.; Hickson, Ryan P.; Stephens, Dana M.; Kennedy, Charles A.

doi:10.1016/j.ajic.2016.04.218

Cited by 26 publications

(25 citation statements)

References 18 publications

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“…The results showed that HAI increased the length of stay and hospitalization costs, with an average of 5 days (increased by 31.25%), and an increase of inpatient costs of €431.34 (increased by 39.38%). We did not classify pathogens, and previous studies had shown that multi-drug resistant nosocomial infections could worsen the financial burden of patients [ 14 – 16 ]. A propensity matched case control study from Singapore, showed that the median per day costs of laboratory tests and antibiotics of patients with HAI were 1.5–2 times higher than that of patients without gram negative bacilli (GNB) infection [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

A multi-center nested case-control study on hospitalization costs and length of stay due to healthcare-associated infection

Cai

Cheng

et al. 2018

Antimicrob Resist Infect Control

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BackgroundIn 2018, the Chinese government demanded nationwide implementation of medical insurance payment methods based on Single-Disease Payment (SDP), but during the operation process the medical insurance system did not fully consider the extra economic burden caused by healthcare-associated infection (HAI). HAIs can prolong the length of stay and increase the hospitalization costs, but only a few studies have been conducted in Sichuan province, China. We evaluated the hospitalization costs and length of stay due to HAI in Sichuan province based on the prevalence survey, and provided data reference for China’s medical insurance reform.MethodsIn the hospitals surveyed on the prevalence of HAI, a multi-center nested case-control study was performed by a paired method. The study period was from 6 September 2016 to 30 November 2016. Binary outcomes were tested using χ2 test, continuous outcomes were tested using Wilcoxon matched-pairs signed rank test, intra-group comparisons were tested using multiple linear regression analysis.ResultsA total of 225 pairs/450 patients were selected in 51 hospitals, and 170 pairs/350 patients were successfully matched. The case fatality rate was 5.14% for the HAIs patients and 3.43% for non-HAs patients, there was no significant difference (χ2 = 0.627, P = 0.429); the median length of stay in patients with HAIs was 21 days, longer than that of patients with non-HAI 16 days, the median of the difference between matched-pairs was 5 days, the difference was statistically significant (Z = 4.896, P = 0.000). The median hospitalization costs of patients with HAI were €1732.83, higher than that of patients with non-HAI €1095.29, the median of the difference between matched-pairs were €431.34, the difference was statistically significant (Z = 6.413, P = 0.000). Multiple linear regression results showed that HAIs at different sites have caused different economic burdens, but in different economic regions, the difference was not statistically significant.ConclusionsIn Sichuan, the hospitalization costs and length of stay caused by HAI should be given special attention in the current medical insurance reform. The proportion and scope of medical payment for patients with HAI at different sites should be different. Efforts need to be taken to incentivize reduction of HAI rates which will reduce hospitalization costs and length of stay.

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Section: Discussionmentioning

confidence: 99%

A multi-center nested case-control study on hospitalization costs and length of stay due to healthcare-associated infection

Cai

Cheng

et al. 2018

Antimicrob Resist Infect Control

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“…The emergence of carbapenemase-producing Enterobacteriaceae (CPE) is concerning, as it further limits options for treatment of infections due to multidrug-resistant Gram-negative bacteria [ 7 ]. It has been described as an imminent threat to global public health with attendant morbidity and mortality [ [8] , [9] , [10] ]. Annually, carbapenem-resistant Gram-negative bacteria cause approximately 9300 infections in the USA, half of which usually result in death [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Phenotypic and genotypic characterization of clinical carbapenem-resistant Enterobacteriaceae isolates from Sokoto, northwest Nigeria

Olowo-Okere

Ibrahim

Olayinka

et al. 2020

New Microbes and New Infections

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Emergence and spread of carbapenemase-producing Enterobacteriaceae (CPE) are two of the major problems currently threatening global public health. In Nigeria, interest in CPE is recent. In Sokoto, northwest Nigeria, there are no data on the prevalence and mechanism underlying carbapenem resistance. In this study, we aimed to investigate the presence of clinical carbapenems-resistant Enterobacteriaceae isolates in two leading hospitals in Sokoto, northwest Nigeria. A total of 292 non-duplicate Enterobacteriaceae isolated from clinical specimens processed in the diagnostic laboratories of two hospitals between January and June 2019 were collected. Of these, 129 (44.2 %) and 19 (6.5%) were resistant to third-generation cephalosporin and carbapenems, respectively. RT-PCR revealed that 10 (7.8%), 19 (14.7%) and 46 (35.7%) of the third-generation cephalosporin-resistant isolates harboured bla SHV , bla TEM and bla CTX-M genes, respectively. The modified Carba NP test result showed that only 7 (36.8 %) of the 19 carbapenem-resistant isolates were carbapenemase producing; among them, bla NDM-5 and bla OXA-181 genes were identified in five and two isolates, respectively. However, none of the carbapenemase genes investigated, including bla VIM , bla KPC and bla IMP , was detected in the remaining carbapenem-resistant isolates, suggesting a non-enzymatic mechanism. This study reports for the first time, the emergence of CPE in Sokoto state and the detection of NDM-producing Citrobacter freundii in Nigeria. The observed CPE in this study is a concern in a country where alternative antibiotics are rarely available.

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“…Meropenem is an important anti-Gram-negative bacteria drug that is often used in the treatment of infections of the abdomen, and the skin. Thus, the TDM of meropenem is highly recommended for patients to avoid a higher risk of kidney failure [ 11 , 14 ] and prevention of the creation of the resistant bacteria which has been spreading recently [ 50 , 51 , 52 , 53 ]. Theophylline is also a crucial drug widely used for the treatment of chronic lung diseases such as asthma and chronic obstructive pulmonary disease.…”

Section: Resultsmentioning

confidence: 99%

A “Single-Use” Ceramic-Based Electrochemical Sensor Chip Using Molecularly Imprinted Carbon Paste Electrode

Aaryashree

Takeda

Kanai

et al. 2020

Sensors

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An inexpensive disposable electrochemical drug sensor for the detection of drugs (vancomycin, meropenem, theophylline, and phenobarbital) is described. Molecularly imprinted polymer (MIP) templated with the target drugs was immobilized on the surface of graphite particles using a simple radical polymerization method and packed into the working electrode of a three-electrode ceramic-based chip sensor. Differential pulse voltammetry (DPV) was used to determine the relationship between the response current and the concentration of the targeted drug while using one sensor chip for one single operation. The time required for each DPV measurement was less than 2 min. Concentrations corresponding to the therapeutic range of these drugs in plasma were taken into account while performing DPV. In all the cases, the single-used MIP sensor showed higher sensitivity and linearity than non-imprinted polymer. The selectivity test in drugs with a structure similar to that of the target drugs was performed, and it was found that MIP-based sensors were more selective than the untreated ones. Additionally, the test in whole blood showed that the presence of interfering species had an insignificant effect on the diagnostic responses of the sensor. These results demonstrate that the disposable MIP-sensor is promising for quick and straightforward therapeutic drug monitoring to prevent the toxic side effects and the insufficient therapeutic effect due to the overdose and underdose, respectively.

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Clinical and economic impact of meropenem resistance in Pseudomonas aeruginosa–infected patients

Cited by 26 publications

References 18 publications

A multi-center nested case-control study on hospitalization costs and length of stay due to healthcare-associated infection

A multi-center nested case-control study on hospitalization costs and length of stay due to healthcare-associated infection

Phenotypic and genotypic characterization of clinical carbapenem-resistant Enterobacteriaceae isolates from Sokoto, northwest Nigeria

A “Single-Use” Ceramic-Based Electrochemical Sensor Chip Using Molecularly Imprinted Carbon Paste Electrode

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