The health and economic burden of bloodstream infections caused by antimicrobial-susceptible and non-susceptible Enterobacteriaceae and Staphylococcus aureus in European hospitals, 2010 and 2011: a multicentre retrospective cohort study

被引：126

作者：

Stewardson, A. J. ^{[1
,2
,3
]}

Allignol, A. ^{[4
,5
]}

Beyersmann, J. ^{[4
]}

Graves, N. ^{[6
]}

Schumacher, M. ^{[5
]}

Meyer, R. ^{[2
,7
]}

Tacconelli, E. ^{[8
,9
]}

De Angelis, G. ^{[8
]}

Farina, C. ^{[10
]}

Pezzoli, F. ^{[10
]}

Bertrand, X. ^{[11
]}

Gbaguidi-Haore, H. ^{[11
]}

Edgeworth, J. ^{[12
]}

Tosas, O. ^{[12
]}

Martinez, J. A. ^{[13
]}

Ayala-Blanco, M. P. ^{[13
]}

Pan, A. ^{[14
]}

Zoncada, A. ^{[14
]}

Marwick, C. A. ^{[15
]}

Nathwani, D. ^{[15
]}

Seifert, H. ^{[16
,17
]}

Hos, N. ^{[16
]}

Hagel, S. ^{[18
]}

Pletz, M. ^{[18
]}

Harbarth, S. ^{[1
,2
]}

机构：

[1] Univ Hosp Geneva, Infect Control Program, Geneva, Switzerland

[2] Fac Med, Geneva, Switzerland

[3] Univ Melbourne, Dept Med, Melbourne, Vic, Australia

[4] Univ Ulm, Inst Stat, Ulm, Germany

[5] Univ Med Ctr Freiburg, Inst Med Biometry & Med Informat, Freiburg, Germany

[6] Queensland Univ Technol, Inst Hlth & Biomed Innovat, Brisbane, Qld, Australia

[7] Univ Hosp Geneva, Informat Technol, Geneva, Switzerland

[8] Agostino Gemelli Hosp, Div Infect Dis, Rome, Italy

[9] Univ Hosp Tubingen, DZIF TTU HAARBI, Div Infect Dis, Tubingen, Germany

[10] Papa Giovanni XXIII Hosp, Bergamo, Italy

[11] Ctr Hosp Reg & Univ CHRU Besancon, Besancon, France

[12] Kings Coll London, Dept Infect Dis, London, England

[13] Hosp Clin Barcelona, Barcelona, Spain

[14] Ist Ospitalieri Cremona, Cremona, Italy

[15] Ninewells Hosp & Med Sch, Dept Infect & Immunodeficiency, Dundee, Scotland

[16] Uniklinik Koln, Cologne, Germany

[17] German Ctr Infect Res DZIF, Braunschweig, Germany

[18] Univ Hosp Jena, Ctr Infect Dis & Infect Control, Jena, Germany

来源：

EUROSURVEILLANCE | 2016年 / 21卷 / 33期

关键词：

LACTAMASE-PRODUCING ENTEROBACTERIACEAE; ANTIBIOTIC-RESISTANCE; TRENDS; STAY;

D O I：

10.2807/1560-7917.ES.2016.21.33.30319

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

We performed a multicentre retrospective cohort study including 606,649 acute inpatient episodes at 10 European hospitals in 2010 and 2011 to estimate the impact of antimicrobial resistance on hospital mortality, excess length of stay (LOS) and cost. Bloodstream infections (BSI) caused by third-generation cephalosporin- resistant Enterobacteriaceae (3GCRE), meticillin-susceptible (MSSA) and - resistant Staphylococcus aureus (MRSA) increased the daily risk of hospital death (adjusted hazard ratio (HR) = 1.80; 95% confidence interval (CI): 1.34-2.42, HR = 1.81; 95% CI: 1.49-2.20 and HR = 2.42; 95% CI: 1.66-3.51, respectively) and prolonged LOS (9.3 days; 95% CI: 9.2-9.4, 11.5 days; 95% CI: 11.5-11.6 and 13.3 days; 95% CI: 13.2-13.4, respectively). BSI with third-generation cephalosporin-susceptible Enterobacteriaceae (3GCSE) significantly increased LOS (5.9 days; 95% CI: 5.8-5.9) but not hazard of death (1.16; 95% CI: 0.98-1.36). 3GCRE significantly increased the hazard of death (1.63; 95% CI: 1.13-2.35), excess LOS (4.9 days; 95% CI: 1.1-8.7) and cost compared with susceptible strains, whereas meticillin resistance did not. The annual cost of 3GCRE BSI was higher than of MRSA BSI. While BSI with S. aureus had greater impact on mortality, excess LOS and cost than Enterobacteriaceae per infection, the impact of antimicrobial resistance was greater for Enterobacteriaceae.

引用

页码：5 / 16

页数：12