Costs and Outcomes of 1-year post-discharge care trajectories of patients admitted with infection due to antibiotic-resistant bacteria

Abstract

Background: The impact of antibiotic resistance (AMR) on initial hospital management has been extensively studied but its consequences after hospital discharge remain largely unknown. We aimed to analyze hospital care trajectories, cumulative length of hospital stays (c-LOS) and associated costs of care over a 1-year period after hospitalization with incident AMR infection. Method: All incident bacterial infection-related hospitalizations occurring from January 1, 2015, to December 31, 2015 and recorded in the French national health data information system were extracted. Bacterial resistance ICD-10 codes determined six infection status. Inpatient and outpatient care consumption and associated costs were studied. The impact of resistance on c-LOS was estimated using a Poisson regression. A sequence analysis through optimal matching method was conducted to identify hospital trajectories along with an extrapolation. Finding: Of the 73,244 patients selected, 15.9% had AMR infection, thus providing 58,286 incident AMR infections after extrapolation. c-LOS was significantly longer for infections with resistant bacteria, reaching 20.4 days and 2.9 additional days IC95%[2.6; 3.2] for skin and soft tissue infections. An estimated 29,793 (51.1%) patients had hospital readmission within the following year, for a total cost of €675 million. Five post-discharge trajectories were identified: Post-hospitalization mainly at home (68.4% of patients); Transition to home from rehabilitation care (12.3%); Early death (< 3 months) (9.7%); Late death (7.4%), and Long-term hospitalization (2.2%). Interpretation: AMR has an impact on patients' c-LOS stay beyond the initial hospitalization. Half of patients hospitalized due to AMR are readmitted to hospital within the ensuing year, along five different trajectories. Funding: French Ministry of health.

Evaluation of The Quality of Antibiotic Use in Urinary Tract Infection Patients in hospitalization installations of NTB Provincial Hospital in 2019

“…Biaya perawatan pasien dengan infeksi yang disebabkan oleh organisme yang telah resisten lebih besar US $ 6.000-30.000 dibanding pasien dengan infeksi bukan disebabkan oleh organisme yang resisten terhadap antibiotik (Maragakis et al, 2008). Lama waktu perawatan di rumah sakit pada pasien infeksi dengan bakteri resisten meningkat sebanyak 20,4 hari (Touat et al, 2021). Melihat berbagai dampak buruk yang terjadi akibat resistensi antibiotik, maka perlu dilakukan upaya untuk mengendalikan kejadian resistensi antibiotik.…”

The Phytochemical Tactics for Battling Antibiotic Resistance in Microbes: Secondary Metabolites and Nano Antibiotics Methods

“…Resistant infections worsen delicate patient states and antimicrobial resistance raises fatality rates. [1] In a recent survey, the Organization for Economic Cooperation and Development (OECD) estimated that 2.4 million humans in Europe, North America, and Australia would die from diseases with resistant bacteria in the next 30 years. [2] Another study revealed that resistance to drugs Acinetobacter baumannii (A. baumannii) strains were shown to be typically resistant to ordinary β-lactamase antibiotics, with or without the inclusion of enzymes.…”

“…Antimicrobial resistance (AMR) is one of the crucial problems in the treatment of bacterial infections. Resistant infections worsen delicate patient states and antimicrobial resistance raises fatality rates [1] . In a recent survey, the Organization for Economic Co‐operation and Development (OECD) estimated that 2.4 million humans in Europe, North America, and Australia would die from diseases with resistant bacteria in the next 30 years [2] .…”

Development of the first edition of African treatment guidelines for common bacterial infections and syndromes

“…[1][2][3] In many countries, drug-resistant infections have been associated with longer hospital stays, increased morbidity and mortality, and higher healthcare costs. [4][5][6] Despite the challenge, antimicrobial stewardship (AMS) solutions are not widespread. [7][8][9][10] Standard treatment guidelines (STGs) are one important tool in ensuring high quality clinical care and prudent antimicrobial use, alongside other AMS and educational efforts.…”