Table 3 Attributable LOS and costs associated with AMR infections from a healthcare system/hospital/charges to patients perspective, 2012–2016
From: Using the best available data to estimate the cost of antimicrobial resistance: a systematic review
Author (year) | Extra LOS due to resistant infection, 95% CI and P value (if indicated) | Cost drivers/costs explored | Type of costs (year of cost data) Excess cost, significance (if indicated) |
|---|---|---|---|
Stewardson (2016) [24] | MRSA: + 2.54 (− 3.19 to 8.27) Third-generation cephalosporin-resistant Enterobacteriaeacea: + 4.89 days (1.11–8.68) | Bed days | Accounting (2011) +€1600 (− 700 to 5000)/ MRSA + €3200 (1600–6000)/ 3GCRE Opportunity +€120 (− 60 to 740)/ MRSA infection +€250 (60–1100)/ 3GCRE infection |
Stewardson (2013) [25] | ESBL+ Enterobacteriaceae: + 6.8 days | Bed days Patient activities Hospital service | Accounting (2009) + CHF 9473/ BSI + CHF 284190 total cost of Enterobacteriaceae |
Neidell (2012) [26] | Resistant Enterococcus: + 0.85 days (− 0.86 to 2.55) Resistant K. pneumoniae: + 1.63 days (− 0.96 to 4.21) Resistant P. aeruginosa: + 3.30 days (0.87–5.73), p = < 0.01 Resistant S.aureus: + 0.42 days (− 2.29 to 3.13) | Bed Days Medications Procedures | Accounting (missing) Enterococcus: +US$16900 (4600–29,300) p < 0.01 KP: +US$13200 (− 5900 to 32,200) NS PA:+US$31400 (10100–52,800) p < 0.01 S. aureus: -US$16000 (− 36,900 to 4800) NS Results of censored models for HAIs provided. |
Campbell (2013) [33] | MRSA: + 5.9 days, p = < 0.0001 | Bed days Laboratory Pharmacy | Accounting (2009) +US$31338 total from index admission, p < 0.05 Results of primary analysis provided. |
Leistner (2014) [29] | ESBL+ E. coli: − 2 days, p = 0.29 | Bed days Medical products Laboratory Pharmacy Staff time Procedures | Accounting (missing) +€38 / patient per day p = 0.69 +€ 1318, p = 0.33 (ICU) +€ 930, p = 0.7 (general ward) - €1479 total hospital cost, p = 0.36 |
Cheah (2013) [31] | VRE:+ 4.89 days (0.56–11.52) | Bed days | Accounting (2010) + AUD $28,872 (734–70,667)/ hospitalisation |
Morales (2012) [27] | Resistant P. aeruginosa: + 13.9 days MDR P. aeruginosa: + 20.6 days, p < 0.00 | Bed days Surgery Laboratory Radiology Pathology Pharmacy | Accounting (missing) Resistant versus non-resistant: +€7418 MDR versus non-resistant: +€10,332 MDR versus resistant: +€2914/ admission p < 0.00 Resistant versus non-resistant OR = 1.37 (95% CI; 1.08–1.72) p = 0.01 MDR versus non-resistant OR 1.77 (95% CI; 1.41–2.22) p < 0.00 |
Maslikowska (2016) [28] | ESBL+(E. coli + Klebsiella spp):+ 2 days, p = 0.024 | Bed days Other costsb | Accounting (missing) Canadian dollar +CAD$2625/ admission p = 0.039 |
Thampi (2015) [20] | MRSA:+ 8.5 days, p = 0.095 | Bed days Human resourcesa Pharmacy Antibiotics Laboratory Diagnostics Operating room | Accounting (2010) Canadian dollar +C$7153/ patient p = 0.029 OR (MRSA) = 1.32 (0.94–1.8), p = 0.1 |
Esteve-Palau (2015) [30] | ESBL+ E. coli: + 4.1 days, p = 0.02 | Bed days OPAT Pharmacy Antibiotics Laboratory Consultations | Accounting (missing) +€1109/ hospitalisation p = 0.01 +€2368/ UTI p < 0.00 +€1389/ OPAT p = 0.04 ESBL versus non-ESBL E. coli OR = 3.1 (1.3–7.0) p = 0.01 |
MacVane (2014) [23] | ESBL+(E. coli + Klebsiella spp):+ 2 days, p = 0.02 | Bed days Antibiotics | Accounting (missing) +US$3189 hospitalisation cost (direct and indirect)/patient (Median loss per patient with ESBL-producing organism versus non-ESBL producing organism.) |
Chandy (2014) [32] | Resistant (all) organisms:+ 3 days, p = 0.03 | Bed days Antibiotics Pharmacy Ward costs | Accounting (missing) Indian rupee +INR 41993 (16667–63,848) /hospitalisation, p = 0.00 |