Hospital costs associated with nosocomial infections in a pediatric intensive care unit

Morillo-García, Áurea; Aldana-Espinal, Josefa María; Lima, Antonio Olry de Labry; Valencia-Martín, Raquel; López-Márquez, Reyes; Loscertales-Abril, M.; Conde-Herrera, Manuel

doi:10.1016/j.gaceta.2015.02.008

Cited by 24 publications

(15 citation statements)

References 29 publications

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“…These differences could be explained by different study populations, with more patients included after cardiac surgery, which may incur lower costs than medical or non-cardiac surgical paediatric ICU patients, and more patients with less organ failure, reflected by mean PeLOD of 7.5 as compared with a median PeLOD of 21 in our study. Third, Morillo-García et al reported higher costs for children with a nosocomial infection, as compared with those without a new infection [ 25 ], which supports our conclusion that healthcare costs can be reduced by preventing new infections.…”

Section: Discussionsupporting

confidence: 87%

Cost-effectiveness study of early versus late parenteral nutrition in critically ill children (PEPaNIC): preplanned secondary analysis of a multicentre randomised controlled trial

et al. 2018

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BackgroundThe multicentre randomised controlled PEPaNIC trial showed that withholding parenteral nutrition (PN) during the first week of critical illness in children was clinically superior to providing early PN. This study describes the cost-effectiveness of this new nutritional strategy.MethodsDirect medical costs were calculated with use of a micro-costing approach. We compared the costs of late versus early initiation of PN (n = 673 versus n = 670 patients) in the Belgian and Dutch study populations from a hospital perspective, using Student’s t test with bootstrapping. Main cost drivers were identified and the impact of new infections on the total costs was assessed.ResultsMean direct medical costs for patients receiving late PN (€26.680, IQR €10.090–28.830 per patient) were 21% lower (-€7.180, p = 0.007) than for patients receiving early PN (€33.860, IQR €11.080–34.720). Since late PN was more effective and less costly, this strategy was superior to early PN. The lower costs for PN only contributed 2.1% to the total cost reduction. The main cost driver was intensive care hospitalisation costs (-€4.120, p = 0.003). The patients who acquired a new infection (14%) were responsible for 41% of the total costs. Sensitivity analyses confirmed consistency across both healthcare systems.ConclusionsLate initiation of PN decreased the direct medical costs for hospitalisation in critically ill children, beyond the expected lower costs for withholding PN. Avoiding new infections by late initiation of PN yielded a large cost reduction. Hence, late initiation of PN was superior to early initiation of PN largely via its effect on new infections.Trial registrationClinicalTrials.gov, NCT01536275. Registered on 16 February 2012.Electronic supplementary materialThe online version of this article (doi:10.1186/s13054-017-1936-2) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 87%

Cost-effectiveness study of early versus late parenteral nutrition in critically ill children (PEPaNIC): preplanned secondary analysis of a multicentre randomised controlled trial

et al. 2018

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“…The last 20 years have been characterized by the emergence and spread of antibiotic-resistant bacteria, which in turn have become a determining factor for the failure of antibiotic therapies, mainly in patients admitted to intensive care units (ICU). (1,2) This public health problem has serious implications on morbidity and mortality rates, and on public health systems stability, provided that both direct and indirect economic costs increase heavily due long-term hospitalizations and greater drug consumption. 3To date, different strategies have been developed to minimize the impact this public health problem can have on health systems, including appropriate antibiotics prescription, cleaning and disinfection programs, antimicrobial stewardship programs, and epidemiological surveillance of antimicrobial resistance.…”

Section: Introductionmentioning

confidence: 99%

Antimicrobial resistance trends in methicillin-resistant and methicillin-susceptible Staphylococcus aureus and Staphylococcus epidermidisisolates obtained from patients admitted to intensive care units. 2010-2015

et al. 2019

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Introducción. La aparición y la diseminación de cepas resistentes en hospitales, principalmente en unidades de cuidado intensivo (UCI), se han convertido en un serio problema de salud pública.Objetivo. Analizar la tendencia de los fenotipos de resistencia de Staphylococcus aureus y Staphylococcus epidermidis resistentes y susceptibles a meticilina aislados en pacientes atendidos en UCI de un hospital de alta complejidad de Cartagena, Colombia, del 2010 al 2015.Materiales y métodos. Estudio analítico transversal realizado entre enero de 2010 y diciembre de 2015. Se utilizaron aislamientos de S. aureus y S. epidermidis meticilino-susceptibles y meticilino-resistentes (SARM, SASR, SERM y SESM). La técnica de susceptibilidad empleada fue el método microdilución en caldo para la detección de la concentración mínima inhibitoria.Resultados. Se identificaron 313 aislamientos de Staphylococcus spp., la mayoría resistentes a meticilina (63.6%). Las cepas SARM y SERM correspondieron al 13.7% y al 27.8% del total de aislamientos, respectivamente. Los mayores porcentajes de resistencia en SARM y SERM correspondieron a eritromicina (57.6% y 81.2%, respectivamente), clindamicina (54.6% y 71.0%), ciprofloxacina (48.4% y 36.4%) y trimetoprima-sulfametoxazol (36.4% y 51.4%).Conclusión. Los resultados encontrados sugieren el replanteamiento de las estrategias de control de la resistencia antimicrobiana en el hospital objeto de estudio.

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“…Nosocomial infections (NI) have become a major problem in many neonatal intensive care units (NICUs) that complicate the hospitalization of patients and result in considerable morbidity and mortality, increased length of stay and increased health care costs. 4,5 The most frequent infections in NICUs are bloodstream infections, pneumonia, and necrotizing enterocolitis (NEC); less frequent complications are infections of the eyes, mouth or skin. 6,7 In developed countries, the incidence rate of nosocomial infections ranges from 6 to 9 infections per 1000 patient-days, with 3-to 20-fold higher rates in developing countries.…”

Section: Introductionmentioning

confidence: 99%

Surveillance of Nosocomial Infections in a Bulgarian Neonatal Intensive Care Unit

Rangelova¹,

Raycheva²,

Kevorkyan³

et al. 2020

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Introduction: Nosocomial infections (NI) are frequent complications in neonatal intensive care units (NICU) which result in high morbidity and mortality. Aim: To determine and analyze the incidence, risk factors and etiologic agents of NI in newborns admitted in the NICU to help plan-ning future surveillance and prevention strategies. Materials and methods: A prospective cohort study was carried out at the NICU of St George University Hospital, Plovdiv, Bul-garia from January 1, 2017 to June 31, 2018. The number of neonates included in the study was 507. Descriptive statistics such as count,  percent, mean and standard deviation was used. Chi-square test was performed to prove associations. Odds ratios, with 95% confidence intervals, were computed from the results of the binominal logistic regression analyses. Results: Of the 507 hospitalized newborns in NICU, 48 presented with 54 NI. The incidence and the density incidence rates were 9.5% and 7.67 per 1,000 patient-days, respectively. Nosocomial infections were detected in neonates from all birth weight (BW) classes, but it was low BW and premature neonates that were at major risk to acquire them. The most common infection sites were ventilator-asso-ciated pneumonia (VAP) (67.27%), bloodstream infection (23.64%) and conjunctivitis (9.09%). Major pathogens were Gram-negative such as Klebsiella pneumoniae, E. coli, Pseudomonas aeruginosa and Acinetobacter baumannii. In the multivariate logistic regression analysis NIs were strongly associated with intubation, presence of a venous catheter, the duration of antibiotic treatment and increased CRP> 10 mg/l. Conclusions: This report highlights the burden of NIs, identifies the major focus for future NI control and prevention programs.

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Hospital costs associated with nosocomial infections in a pediatric intensive care unit

Abstract: NI was associated with an increase in total cost, which implies that the prevention of these infections through specific interventions could be cost-effective and would help to increase the safety of healthcare systems.

Cited by 24 publications

References 29 publications

Cost-effectiveness study of early versus late parenteral nutrition in critically ill children (PEPaNIC): preplanned secondary analysis of a multicentre randomised controlled trial

Cost-effectiveness study of early versus late parenteral nutrition in critically ill children (PEPaNIC): preplanned secondary analysis of a multicentre randomised controlled trial

Antimicrobial resistance trends in methicillin-resistant and methicillin-susceptible Staphylococcus aureus and Staphylococcus epidermidisisolates obtained from patients admitted to intensive care units. 2010-2015

Surveillance of Nosocomial Infections in a Bulgarian Neonatal Intensive Care Unit

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