Budget impact analysis of routinely using whole-genomic sequencing of six multidrug-resistant bacterial pathogens in Queensland, Australia

被引:23
作者
Gordon, Louisa G. [1 ,2 ,3 ]
Elliott, Thomas M. [1 ]
Forde, Brian [4 ,5 ]
Mitchell, Brett [6 ]
Russo, Philip L. [7 ]
Paterson, David L. [5 ]
Harris, Patrick N. A. [5 ,8 ]
机构
[1] QIMR Berghofer Med Res Inst, Populat Hlth Dept, Brisbane, Qld, Australia
[2] Queensland Univ Technol QUT, Sch Nursing, Brisbane, Qld, Australia
[3] Univ Queensland, Sch Publ Hlth, Brisbane, Qld, Australia
[4] Univ Queensland, Sch Chem & Mol Biosci, Brisbane, Qld, Australia
[5] Univ Queensland, Ctr Clin Res, Brisbane, Qld, Australia
[6] Univ Newcastle, Sch Nursing & Midwifery, Newcastle, NSW, Australia
[7] Monash Univ, Sch Nursing & Midwifery, Melbourne, Vic, Australia
[8] Queensland Hlth, Pathol Queensland, Brisbane, Qld, Australia
来源
BMJ OPEN | 2021年 / 11卷 / 02期
关键词
microbiology; health economics; infection control; HOSPITALS; COST;
D O I
10.1136/bmjopen-2020-041968
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective To predict the cost and health effects of routine use of whole-genome sequencing (WGS) of bacterial pathogens compared with those of standard of care. Design Budget impact analysis was performed over the following 5 years. Data were primarily from sequencing results on clusters of multidrug-resistant organisms across 27 hospitals. Model inputs were derived from hospitalisation and sequencing data, and epidemiological and costing reports, and included multidrug resistance rates and their trends. Setting Queensland, Australia. Participants Hospitalised patients. Interventions WGS surveillance of six common multidrug-resistant organisms (Staphylococcus aureus, Escherichia coli, Enterococcus faecium, Klebsiella pneumoniae, Enterobacter sp and Acinetobacter baumannii) compared with standard of care or routine microbiology testing. Primary and secondary outcomes Expected hospital costs, counts of patient infections and colonisations, and deaths from bloodstream infections. Results In 2021, 97 539 patients in Queensland are expected to be infected or colonised with one of six multidrug-resistant organisms with standard of care testing. WGS surveillance strategy and earlier infection control measures could avoid 36 726 infected or colonised patients and avoid 650 deaths. The total cost under standard of care was $A170.8 million in 2021. WGS surveillance costs an additional $A26.8 million but was offset by fewer costs for cleaning, nursing, personal protective equipment, shorter hospital stays and antimicrobials to produce an overall cost savings of $30.9 million in 2021. Sensitivity analyses showed cost savings remained when input values were varied at 95% confidence limits. Conclusions Compared with standard of care, WGS surveillance at a state-wide level could prevent a substantial number of hospital patients infected with multidrug-resistant organisms and related deaths and save healthcare costs. Primary prevention through routine use of WGS is an investment priority for the control of serious hospital-associated infections.
引用
收藏
页数:10
相关论文
共 30 条
  • [1] AIHW, 2019, GEN REC INC MORT GRI
  • [2] Colistin Dosage without Loading Dose Is Efficacious when Treating Carbapenem-Resistant Acinetobacter baumannii Ventilator-Associated Pneumonia Caused by Strains with High Susceptibility to Colistin
    Alvarez-Marin, Rocio
    Lopez-Rojas, Rafael
    Antonio Marquez, Juan
    Jose Gomez, Maria
    Molina, Jose
    Miguel Cisneros, Jose
    Ortiz-Leyba, Carlos
    Aznar, Javier
    Garnacho-Montero, Jose
    Pachon, Jeronimo
    [J]. PLOS ONE, 2016, 11 (12):
  • [3] Care ACoSaQiH, 2018, AUSTR PASSIVE ANTIMI
  • [4] Genomic Investigation Reveals Contaminated Detergent as the Source of an Extended-Spectrum-β-Lactamase-Producing Klebsiella michiganensis Outbreak in a Neonatal Unit
    Chapman, Paul
    Forde, Brian M.
    Roberts, Leah W.
    Bergh, Haakon
    Vesey, Debra
    Jennison, Amy V.
    Moss, Susan
    Paterson, David L.
    Beatson, Scott A.
    Harris, Patrick N. A.
    [J]. JOURNAL OF CLINICAL MICROBIOLOGY, 2020, 58 (05)
  • [5] Coombs G., 2019, Australian group on Antimicrobial Resistance Sepsis Outcomes Programs: 2017 Report
  • [6] Genomic Surveillance of Methicillin-resistant Staphylococcus aureus: A Mathematical Early Modeling Study of Cost-effectiveness
    Dymond, Amy
    Davies, Heather
    Mealing, Stuart
    Pollit, Vicki
    Coll, Francesc
    Brown, Nicholas M.
    Peacock, Sharon J.
    [J]. CLINICAL INFECTIOUS DISEASES, 2020, 70 (08) : 1613 - 1619
  • [7] A hybrid simulation model approach to examine bacterial genome sequencing during a hospital outbreak
    Elliott, Thomas M.
    Lee, Xing J.
    Foeglein, Anna
    Harris, Patrick N.
    Gordon, Louisa G.
    [J]. BMC INFECTIOUS DISEASES, 2020, 20 (01)
  • [8] Estimating the costs of genomic sequencing in cancer control
    Gordon, Louisa G.
    White, Nicole M.
    Elliott, Thomas M.
    Nones, Katia
    Beckhouse, Anthony G.
    Rodriguez-Acevedo, Astrid J.
    Webb, Penelope M.
    Lee, Xing J.
    Graves, Nicholas
    Schofield, Deborah J.
    [J]. BMC HEALTH SERVICES RESEARCH, 2020, 20 (01)
  • [9] Health Q, 2020, Q HOSP ACTIVITY INFO
  • [10] Health SA, 2019, STAPHYLOCOCCUS AUREU