Factores de riesgo de infección por Clostridium difficile en pacientes hospitalizados

Martín, Diana Monge; Morosini, M; Millán, Isabel; Canosa, Carmen Pérez; Manso, Marta; Guzman, Maria Fernanda González; Asensio, Ángel

doi:10.1016/j.medcli.2010.12.026

Cited by 16 publications

(7 citation statements)

References 27 publications

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“…Aunque se dispone de varios estudios que estiman el uso de recursos en los pacientes con DACD, no distinguen los costes exclusivos de la DACD 6,9 . Solo se ha identificado un estudio que intenta estimar la carga de la DACD en España 10 .…”

Section: Discussionunclassified

“…Se consideró que en España se producen 4.720.545 altas hospitalarias al año 11 , que la incidencia anual media de la DACD es de 17,1 casos (12,2-24,0) por cada 10.000 altas hospitalarias 3-5 y una tasa de letalidad global en los casos de DACD del 31% 6 , oscilando entre el 12,3% y el 48,0% 4,6 . Estas tasas de letalidad (debidas a todas las causas: la enfermedad de base, la DACD y demás) se utilizaron para calcular el número neto de pacientes con DACD (tabla 1).…”

Section: Materials Y Métodosunclassified

“…La incidencia anual de la DACD en España se estima en 17,1 casos por cada 10.000 pacientes hospitalizados 3 oscilando entre 12,2 y 24,0 casos por cada 10.000 altas e ingresos hospitalarios, respectivamente 4,5 . En un reciente estudio español, la letalidad hospitalaria fue muy superior en los casos con DACD (31%) en comparación con los controles que no presentaban esta infección (6,6%) 6 .…”

Section: Introductionunclassified

“…Se dispone de pocos estudios publicados que intentaron estimar el consumo de recursos asociados a la DACD en España 6,9 . Sin embargo, no discriminaron el consumo de recursos realmente debidos a la DACD, separándolos de los originados por la enfermedad de base.…”

Section: Introductionunclassified

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Coste de la diarrea asociada a Clostridium difficile en España

Asensio

Bouza

Grau

et al. 2013

Rev. Esp. Salud Publica

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RESUMENFundamentos: No se dispone de estudios adecuados del coste de las diarreas asociadas a Clostridium difficile (DACD) en España. El objetivo del estudio es estimar el coste de las DACD para el Sistema Nacional de Salud (SNS). Métodos:Se realizó un modelo económico para calcular el coste por episodio de DACD (por antibióticos, prolongación del ingreso hospitalario, procedimientos quirúrgicos, medidas de control de la infección, recurrencias de las infecciones tratadas) y el coste anual de la DACD. El uso de recursos en la práctica clínica se obtuvo mediante un panel Delphi de clínicos españoles con experiencia en la DACD y los costes unitarios (€ 2012) de fuentes españolas.Resultados: Se estimó que anualmente se produjeron 7.601 episodios de DACD en España (incidencia de 17,1 episodios/año/10.000 altas hospitalarias) con un gasto anual para el SNS de 32.157.093 €. Coste por episodio de DACD: 3.901 € (infección inicial), 4.875 € (primera recurrencia) y 5.916 € (segunda recurrencia). Coste total de las recurrencias: 10.426.750 € anuales. El 95,6% del gasto se debería a la prolongación de la duración de la estancia hospitalaria, el 0,5% a tratamientos antibióticos, el 2,8% a intervenciones quirúrgicas y el 1,1% a las medidas de control de la infección. Los resultados del estudio fueron sensibles a la incidencia y tasa de letalidad de la DACD en España y a la duración de la prolongación de la duración de la estancia hospitalaria debida a la DACD.Conclusiones: Según este estudio, el gasto asociado a la DACD se debe fundamentalmente a la prolongación de los ingresos hospitalarios y tiene un gran impacto económico en el SNS.Palabras clave: Clostridium difficile. Diarrea. Vancomicina. Metronidazol. Coste de la enfermedad.

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Section: Discussionunclassified

Section: Materials Y Métodosunclassified

Section: Introductionunclassified

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Coste de la diarrea asociada a Clostridium difficile en España

Asensio

Bouza

Grau

et al. 2013

Rev. Esp. Salud Publica

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“…The annual incidence of CDI in Spain is estimated at 3.2-3.5 cases per 10,000 hospitalised patients [10]. In a Spanish study, the crude hospital mortality rate was higher in cases with CDI (31 %) than in controls that did not present this infection (6.6 %) [11]. According to a different study, it is estimated that there are approximately 7,600 episodes of CDI per year in Spain, with a financial burden of €32,157,093 on the National Health System (NHS) [12].…”

Section: Introductionmentioning

confidence: 95%

Economic assessment of fidaxomicin for the treatment of Clostridium difficile infection (CDI) in special populations (patients with cancer, concomitant antibiotic treatment or renal impairment) in Spain

Rubio-Terrés

Reinoso

Cerrato

et al. 2015

Eur J Clin Microbiol Infect Dis

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The objective of this paper was to assess the cost-utility of fidaxomicin versus vancomycin in the treatment of Clostridium difficile infection (CDI) in three specific CDI patient subgroups: those with cancer, treated with concomitant antibiotic therapy or with renal impairment. A Markov model with six health states was developed to assess the cost-utility of fidaxomicin versus vancomycin in the patient subgroups over a period of 1 year from initial infection. Cost and outcome data used to parameterise the model were taken from Spanish sources and published literature. The costs were from the Spanish hospital perspective, in Euros (€) and for 2013. For CDI patients with cancer, fidaxomicin was dominant versus vancomycin [gain of 0.016 quality-adjusted life-years (QALYs) and savings of €2,397 per patient]. At a cost-effectiveness threshold of €30,000 per QALY gained, the probability that fidaxomicin was cost-effective was 96 %. For CDI patients treated with concomitant antibiotic therapy, fidaxomicin was the dominant treatment versus vancomycin (gain of 0.014 QALYs and savings of €1,452 per patient), with a probability that fidaxomicin was cost-effective of 94 %. For CDI patients with renal impairment, fidaxomicin was also dominant versus vancomycin (gain of 0.013 QALYs and savings of €1,432 per patient), with a probability that fidaxomicin was cost-effective of 96 %. Over a 1-year time horizon, when fidaxomicin is compared to vancomycin in CDI patients with cancer, treated with concomitant antibiotic therapy or with renal impairment, the use of fidaxomicin would be expected to result in increased QALYs for patients and reduced overall costs.

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Age and gender differences in Clostridium difficile-related hospitalization trends in Madrid (Spain) over a 12-year period

Esteban-Vasallo¹,

Pellicer²,

Domínguez‐Berjón³

et al. 2016

Eur J Clin Microbiol Infect Dis

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This study aimed to analyze temporal trends by gender and age in Clostridium difficile infection (CDI)-related hospitalization rates in the Autonomous Community of Madrid (Spain) over a 12-year period. A population-based cross-sectional study of all hospital admissions with a CDI diagnosis from 2003 to 2014 was carried out. Annual age-specific hospitalization rates were calculated by gender. All the analyses were performed separately for total hospitalizations and hospitalizations with CDI as the primary diagnosis. Joinpoint regression models were used to analyze time trends. A total of 13,526 hospital discharges were identified (26.8 % with CDI as the primary diagnosis). In both sexes, a gradient in age-specific rates was observed, ranging in 2014 from 5.92 hospitalizations per 100,000 person-years in patients <15 years of age to 378.96 in patients ≥85 years of age. Since 2009, in the age group of 15-44 years, both men and women presented an increasing trend of around 18 %. A significantly increasing trend was detected in women of age 45-84 years, with an estimated annual percentage of change of 7.6 % in the age group of 45-64 years, and rounding with 4.5 % in the age group of 65-84 years. In men of age 45-64 years, the average annual percentage of increase was 4.7 %, and it was 21.1 % between 2010 and 2014 in the age group of 65-74 years. No trends were identified in the 85 years and over age group. Surveillance methods to assess trends by age group should be implemented. Preventive and therapeutic initiatives should remain a priority.

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Factores de riesgo de infección por Clostridium difficile en pacientes hospitalizados

Cited by 16 publications

References 27 publications

Coste de la diarrea asociada a Clostridium difficile en España

Coste de la diarrea asociada a Clostridium difficile en España

Economic assessment of fidaxomicin for the treatment of Clostridium difficile infection (CDI) in special populations (patients with cancer, concomitant antibiotic treatment or renal impairment) in Spain

Age and gender differences in Clostridium difficile-related hospitalization trends in Madrid (Spain) over a 12-year period

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