NDLI: Incremental costs of hospital-acquired infections in COVID-19 patients in an adult intensive care unit of a tertiary hospital from a low-resource setting

Content Provider	Springer Nature : BioMed Central
Author	Despotović, Aleksa Milić, Nataša Cirković, Anđa Milošević, Branko Jovanović, Snežana Mioljević, Vesna Obradović, Vesna Kovačević, Gordana Stevanović, Goran
Abstract	Background Hospital-acquired infections (HAIs) are a global public health problem and put patients at risk of complications, including death. HAIs increase treatment costs, but their financial impact on Serbia’s healthcare system is unknown. Our goal was to assess incremental costs of HAIs in a tertiary care adult intensive care unit (ICU) that managed COVID-19 patients. Methods A retrospective study from March 6th to December 31st, 2020 included patients with microbiologically confirmed COVID-19 (positive rapid antigen test or real-time polymerase chain reaction) treated in the ICU of the Teaching Hospital for Infectious and Tropical Diseases, University Clinical Centre of Serbia. Demographic and HAI-specific data acquired in our ICU were collected, including total and stratified medical costs (services, materials, laboratory testing, medicines, occupancy costs). Median total and stratified costs were compared in relation to HAI acquisition. Linear regression modelling was used to assess incremental costs of HAIs, adjusted for age, biological sex, prior hospitalisation, Charlson Comorbidity Index (CCI), and Glasgow Coma Scale (GCS) on admission. Outcome variables were length of stay (LOS) in days and mortality. Results During the study period, 299 patients were treated for COVID-19, of which 214 were included. HAIs were diagnosed in 56 (26.2%) patients. Acinetobacter spp. was the main pathogen in respiratory (38, 45.8%) and bloodstream infections (35, 42.2%), the two main HAI types. Median total costs were significantly greater in patients with HAIs (€1650.4 vs. €4203.2, p < 0.001). Longer LOS (10.0 vs. 18.5 days, p < 0.001) and higher ICU mortality (51.3% vs. 89.3%, p < 0.001) were seen if HAIs were acquired. Patients with ≥ 2 HAIs had the highest median total costs compared to those without HAIs or with a single HAI (€1650.4 vs. €3343.4 vs. €7336.9, p < 0.001). Incremental costs in patients with 1 and ≥ 2 HAIs were €1837.8 (95% CI 1257.8–2417.7, p < 0.001) and €5142.5 (95% CI 4262.3–6022.7, p < 0.001), respectively. Conclusions This is the first economic evaluation of HAIs in Serbia, showing significant additional costs to our healthcare system. HAIs prolong LOS and influence ICU mortality rates. Larger economic assessments are needed to enhance infection control practices.
Related Links	https://aricjournal.biomedcentral.com/counter/pdf/10.1186/s13756-023-01240-0.pdf
Ending Page	11
Page Count	11
Starting Page	1
File Format	HTM / HTML
ISSN	20472994
DOI	10.1186/s13756-023-01240-0
Journal	Antimicrobial Resistance & Infection Control
Issue Number	1
Volume Number	12
Language	English
Publisher	BioMed Central
Publisher Date	2023-04-21
Access Restriction	Open
Subject Keyword	Medical Microbiology Drug Resistance Infectious Diseases Hospital-acquired infections Intensive care unit Medical costs Economic evaluation COVID-19 Serbia
Content Type	Text
Resource Type	Article
Subject	Public Health, Environmental and Occupational Health Infectious Diseases Microbiology (medical) Pharmacology (medical)
Journal Impact Factor	4.8/2023
5-Year Journal Impact Factor	5.8/2023

Sl.	Authority	Responsibilities	Communication Details
1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
5	Website/Portal (Helpdesk)	Queries regarding NDLI and its services	support@ndl.gov.in
6	Contents and Copyright Issues	Queries related to content curation and copyright issues	content@ndl.gov.in
7	National Digital Library of India Club (NDLI Club)	Queries related to NDLI Club formation, support, user awareness program, seminar/symposium, collaboration, social media, promotion, and outreach	clubsupport@ndl.gov.in
8	Digital Preservation Centre (DPC)	Assistance with digitizing and archiving copyright-free printed books	dpc@ndl.gov.in
9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in

Healthcare‑associated infections in intensive care unit patients with and without COVID-19: a single center prospective surveillance study

No increase of device associated infections in German intensive care units during the start of the COVID-19 pandemic in 2020

Consumption of carbapenems in different intensive care units in a Saudi tertiary care hospital

The impact of the COVID-19 pandemic on healthcare-associated infections in intensive care unit patients: a retrospective cohort study

Klebsiella pneumoniae infections in COVID-19 patients: a 2-month retrospective analysis in an Italian hospital.

Antibiotic prescribing in neonatal intensive care units of two tertiary care hospitals at central India

Nosocomial infections among COVID-19 patients: an analysis of intensive care unit surveillance data

COVID-19 associated infections in the ICU setting: A retrospective analysis in a tertiary-care hospital.

Nosocomial cluster of carbapenemase-producing Enterobacter cloacae in an intensive care unit dedicated COVID-19

Incremental costs of hospital-acquired infections in COVID-19 patients in an adult intensive care unit of a tertiary hospital from a low-resource setting

Similar Documents

Healthcare‑associated infections in intensive care unit patients with and without COVID-19: a single center prospective surveillance study

No increase of device associated infections in German intensive care units during the start of the COVID-19 pandemic in 2020

Consumption of carbapenems in different intensive care units in a Saudi tertiary care hospital

The impact of the COVID-19 pandemic on healthcare-associated infections in intensive care unit patients: a retrospective cohort study

Klebsiella pneumoniae infections in COVID-19 patients: a 2-month retrospective analysis in an Italian hospital.

Antibiotic prescribing in neonatal intensive care units of two tertiary care hospitals at central India

Nosocomial infections among COVID-19 patients: an analysis of intensive care unit surveillance data

COVID-19 associated infections in the ICU setting: A retrospective analysis in a tertiary-care hospital.

Nosocomial cluster of carbapenemase-producing Enterobacter cloacae in an intensive care unit dedicated COVID-19

Incremental costs of hospital-acquired infections in COVID-19 patients in an adult intensive care unit of a tertiary hospital from a low-resource setting