Economic Burden of Multidrug-Resistant Gram-Negative Infections in a Developing Country

Objective: Antibiotic-resistant infections represent a significant global public health threat due to their rising prevalence. The aim of this study is to identify risk factors for acquisition of multidrug-resistant gram negatives (MDR-GNs) in the first intensive care unit (ICU) infection episode of patients and also to calculate the economic burden of infection with MDR-GNs that the ICU patient faced. Materials and Methods: This is a prospective observational study conducted over 1 year. The first ICU infection episode of the patients was included into this study. A case was defined as a patient who had an MDR-GN in his or her first episode of an ICU infection, and control was defined as a patient who had a non-MDR-GN in his or her first episode of an ICU infection. Results: A total of 100 patients were included into the study. Sixty-two patients had the MDR-GN, and 38 patients had a non-MDR pathogen. Independent risk factors associated with the MDR-GN infection were the APACHE II score (OR=1.08, p=0.012), transfer from another hospital (OR=9.3, p=0.04), antibiotic use before ICU infection (OR=7.7, p=0.04), and arterial catheter (OR=2.8, p=0.03). The median antibiotic cost was significantly higher for patients in the case group [$663.50 (27–3,752) and $256.00 (0–2,716), respectively] (p

Kaynakça

Giske CG, Monnet DL, Cars O, Carmeli Y; ReAct-Action on Antibiotic Resistance. Clinical and economic impact of common multidrug-resistant gram-negative bacilli. Antimicrob Agents Chemother 2008; 52(3): 813–21. [CrossRef]

Cerceo E, Deitelzweig SB, Sherman BM, Amin AN. Multidrug-Resistant Gram-Negative Bacterial Infections in the Hospital Setting: Overview, Implications for Clinical Practice, and Emerging Treatment Options. Microb Drug Resist 2016; 22(5): 412–31. [CrossRef]

Siwakoti S, Subedi A, Sharma A, Baral R, Bhattarai NR, Khanal B. Incidence and outcomes of multidrug-resistant gram-negative bacteria infections in intensive care unit from Nepal- a prospective cohort study. Antimicrob Resist Infect Control 2018; 7: 114. [CrossRef]

Centers for Disease Control and Prevention/ National Healthcare Safety Network. CDC/ NHSN Surveillance Definitions for Specific Types of Infections. January 2017. Available from: URL: https:// www.cdc.gov/ nhsn/ pdfs/ pscmanual/ 17pscnos infdef_current.pdf.

Magiorakos AP, Srinivasan A, Carey RB, Carmeli Y, Falagas ME, Giske CG, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012; 18(3): 268–81. [CrossRef]

Oliva A, Giacobbe DR, Di Luca M, Miller NS. New Insights into Infections due to Multidrug Resistant Gram Negative Bacteria: The Interplay between Lab and Clinic. Biomed Res Int 2018; 2018: 8905874.

Ibrahim ME. High antimicrobial resistant rates among Gram-negative pathogens in intensive care units. A retrospective study at a tertiary care hospital in Southwest Saudi Arabia. Saudi Med J 2018; 39(10): 1035–43. [CrossRef]

Thaden JT, Li Y, Ruffin F, Maskarinec SA, Hill-Rorie JM, Wanda LC, et al. Increased Costs Associated with Bloodstream Infections Caused by Multidrug-Resistant Gram-Negative Bacteria Are Due Primarily to Patients with Hospital-Acquired Infections. Antimicrob Agents Chemother 2017; 61(3).pii: e01709–16. [CrossRef]

Ulu-Kilic A, Alp E, Percin D, Cevahir F, Altay-Kürkçü C, Ozturk A, et al. Risk factors for carbapenem resistant Klebsiella pneumoniae rectal colonization in pediatric units. J Infect Dev Ctries 2014; 8(10): 1361–4.

Halaby T, Al Naiemi N, Beishuizen B, Verkooijen R, Ferreira JA, Klont R, et al. Impact of single room design on the spread of multi-drug resistant bacteria in an intensive care unit. Antimicrob Resist Infect Control 2017; 6: 117. [CrossRef]

Kaynak Göster

  • ISSN: 2149-2247
  • Yayın Aralığı: Yılda 6 Sayı
  • Başlangıç: 2002
  • Yayıncı: Kare Yayıncılık

2.3b 1.8b

Sayıdaki Diğer Makaleler

Cardiovascular Risk Factors and Metabolic Syndrome in Rheumatoid Arthritis and Spondyloarthritis: Correlation With Uric Acid Levels

EZGİ AĞADAYI, Fatma Gül YURDAKUL, Sıtkı AĞADAYI, Hatice BODUR, Rabia KAHVECİ, ADEM ÖZKARA

The Effect of Lymph Node Dissection on Gallstone Formation in Patients Undergoing Total Gastrectomy for Gastric Adenocarcinoma

İSMAİL CEM ERAY, UĞUR TOPAL, Erdem KAKİL, AHMET GÖKHAN SARITAŞ, AHMET RENCÜZOĞULLARI, ORÇUN YALAV, Kubilay DALCI

Pericarditis: Are There Any Changes Since 1761? A Panoramic View of Pericarditis

DENİZ ELÇİK, Ali ERGİN

Nail Digital Dermoscopy in Onychomycosis: A Correlation with Clinical Type, Gender, and Culture Examination

ZEYNEP GİZEM KAYA İSLAMOĞLU, Abdullah DEMİRBAŞ, Mehmet ÜNAL, DUYGU FINDIK

A Dangerous Furuncle Involving the Nasal Vestibule

Satvinder Singh BAKSHI

The Turkish Version of the Infant Feeding Intention Instrument (IFI-T)

SEZER ER GÜNERİ, GONCA KARAYAĞIZ MUSLU, ÖZLEM GÜNER

Adverse Effect of the Neuronal Cells and the Coronary Artery Endothelium in Extreme Environments—Roles of Advanced Molecular Imaging Markers

Fathinul Fikri Ahmad SAAD, Subapriya SUPPIAH, Shazreen SHAHARUDIN

The Effect of Carbapenem Restriction Policy on the Rate of Hospital Infections Due To Resistant Microorganisms in the Intensive Care Unit

Zeynep TÜRE, Gökşen ÖZ, Tuğba DEMİREL GÜĞÜL, ŞERİFE ÇETİN, Tuğba BULUT, Saliha AYDIN, İLHAMİ ÇELİK

Residual Kidney Function in Hemodialyzed Patients and Related Factors

HALİL İBRAHİM ERDOĞDU, FATİH KARA

The Effect of Aminoglycosides on Colistin-Containing Regimens in the Treatment of Carbapenem-Resistant Gram-Negative Infections in Pediatric Intensive Care Units: A Two-Center Experience

Zümrüt ŞAHBUDAK BAL, Fulya KAMİT, Muhterem DUYU, Pınar YAZICI, Ayşe Berna ANIL, Dilek ÇİFTDOĞAN YILMAZ, Nisel ÖZKALAY YILMAZ, Feriha ÇİLLİ, BÜLENT KARAPINAR