Direct costs associated with a nosocomial outbreak of Salmonella infection: An ounce of prevention is worth a pound of cure

Spearing, Natalie; Jensen, A.; McCall, Bradley J; Neill, Annette; McCormack, J. G.

doi:10.1016/s0196-6553(00)90012-9

Cited by 34 publications

(22 citation statements)

References 10 publications

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“…Other investigators have demonstrated that outbreaks of infection significantly increase total expenses for hospitals. 10,11 However, although we should be cautious about comparing studies directly because of differences in the methods used to calculate costs, the estimates of excess cost due to the an emerging pathogen outbreak, namely SARS, in our study were much higher than estimates reported in these studies. For example, one study found that the excess cost to the hospital per infected or colonized infant was estimated to be $16,000 during an outbreak of infection due to extended-spectrum /3-lactamase-producing Klebsiella pneumoniae in a neonatal intensive care unit.…”

Section: N F E C T I O N Control and Hospital Epidemiologycontrasting

confidence: 61%

Analysis of Costs Attributable to an Outbreak of Severe Acute Respiratory Syndrome at a French Hospital

Yazdanpanah

Daval

Alfandari

et al. 2006

Infect. Control Hosp. Epidemiol.

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Other potential reservoirs (eg, shaving cream, povidoneiodine solution, water supplies, and an alcohol-based mouthwash) were culture negative for B. cepacia.Samples were obtained from unopened bottles of mouthwash distributed around the hospital that belonged to different batches, and the samples were cultured. Batches distributed from August 2004 through September 2004 were not contaminated. Batches distributed from April-2005 through July 2005 were highly contaminated. No other samples were available for analysis. The distribution of contaminated batches matched the substantial increase in the incidence of B. cepacia infection or colonization.Strains from 5 patients and 6 mouthwash samples were submitted for identification to our reference center (National Center of Microbiology, Health Institute Carlos III, Majadahonda, Madrid, Spain). Pulsed-field gel electrophoresis of Xbal-digested genomic DNA was performed with a Chief DR-III system (Bio-Rad) according to conditions described elsewhere, 10 with several modifications. Briefly, electrophoresis was carried out in a 1.2% agarose gel for 22 hours at 6 V/cm with pulse times ranging from 5 to 35 seconds. Molecular mass markers were concatameters of phage X New England (Biolabs, UK). Electrophoretic patterns showed that all the strains were identical (Figure).On July 18, the use of the mouthwash product in our hospital was discontinued, and the last isolate of B. cepacia was obtained on July 22, 2005. The methods of production and distribution and the extent of use of this mouthwash in other hospitals are now being investigated by the Spanish Department of Health. At the moment, no information is available on the rate of B. cepacia infection or colonization at other hospitals that used the same product distributed by the same company as at our hospital.Our findings strongly suggest that intrinsically contaminated alcohol-free mouthwash solution was the source of this large outbreak involving predisposed adults in ICU. To date, 2 similar outbreaks in which B. cepacia was isolated from culture of respiratory tract specimens from patients without cystic fibrosis have been traced to intrinsically contaminated alcohol-free mouthwash in North America. More-thorough surveillance of microbiological contamination of alcohol-free products used in adults predisposed to infection should be mandatory. These findings highlight the importance of hospital surveillance and investigation of unusual clusters of infection and colonization to promptly identify unexpected sources of pathogens and to protect patients at risk.

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Section: N F E C T I O N Control and Hospital Epidemiologycontrasting

confidence: 61%

Analysis of Costs Attributable to an Outbreak of Severe Acute Respiratory Syndrome at a French Hospital

Yazdanpanah

Daval

Alfandari

et al. 2006

Infect. Control Hosp. Epidemiol.

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“…This issue has also proved to be critical in some nosocomial foodborne outbreaks [7-11]. Hence, a major goal of the hospital is to provide safe food to patients who frequently are at higher risk of acquiring infections and their complications [12,13].…”

Section: Introductionmentioning

confidence: 99%

Food safety in hospital: knowledge, attitudes and practices of nursing staff of two hospitals in Sicily, Italy

Buccheri¹,

Casuccio²,

Giammanco³

et al. 2007

BMC Health Serv Res

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Background: Food hygiene in hospital poses peculiar problems, particularly given the presence of patients who could be more vulnerable than healthy subjects to microbiological and nutritional risks. Moreover, in nosocomial outbreaks of infectious intestinal disease, the mortality risk has been proved to be significantly higher than the community outbreaks and highest for foodborne outbreaks. On the other hand, the common involvement in the role of food handlers of nurses or domestic staff, not specifically trained about food hygiene and HACCP, may represent a further cause of concern.

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“…A pertussis outbreak incurred total hospital costs of $34,956 and $50,668 in two hospitals 61. The attributable costs during a Salmonella outbreak in one Australian tertiary care complex were reported in total costs rather than per case, and dividing by the number of cases yields an estimate of $2552 per case 62. One retrospective case control study defined a case as a multidrug-resistant infection of Acinetobacter baumannii in burn patients, and reported a mean additional cost per case of $121,371 63.…”

Section: Surgical Site Infectionsmentioning

confidence: 99%

The economic burden of patient safety targets in acute care: a systematic review

Mittmann

Koo²,

Daneman³

et al. 2012

DHPS

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BackgroundOur objective was to determine the quality of literature in costing of the economic burden of patient safety.MethodsWe selected 15 types of patient safety targets for our systematic review. We searched the literature published between 2000 and 2010 using the following terms: “costs and cost analysis,” “cost-effectiveness,” “cost,” and “financial management, hospital.” We appraised the methodologic quality of potentially relevant studies using standard economic methods. We recorded results in the original currency, adjusted for inflation, and then converted to 2010 US dollars for comparative purposes (2010 US$1.00 = 2010 €0.76). The quality of each costing study per patient safety target was also evaluated.ResultsWe screened 1948 abstracts, and identified 158 potentially eligible studies, of which only 61 (39%) reported any costing methodology. In these 61 studies, we found wide estimates of the attributable costs of patient safety events ranging from $2830 to $10,074. In general hospital populations, the cost per case of hospital-acquired infection ranged from $2132 to $15,018. Nosocomial bloodstream infection was associated with costs ranging from $2604 to $22,414.ConclusionThere are wide variations in the estimates of economic burden due to differences in study methods and methodologic quality. Greater attention to methodologic standards for economic evaluations in patient safety is needed.

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Direct costs associated with a nosocomial outbreak of Salmonella infection: An ounce of prevention is worth a pound of cure

Cited by 34 publications

References 10 publications

Analysis of Costs Attributable to an Outbreak of Severe Acute Respiratory Syndrome at a French Hospital

Analysis of Costs Attributable to an Outbreak of Severe Acute Respiratory Syndrome at a French Hospital

Food safety in hospital: knowledge, attitudes and practices of nursing staff of two hospitals in Sicily, Italy

The economic burden of patient safety targets in acute care: a systematic review

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