Health and economic burden due to ESBLs-producing Klebsiella pneumoniae infection in a three-A hospital of Jiangxi Province
OBJECTIVE To understand the health and economic burden due to extended-spectrum β-lactamases(ES-BLs)-producing Klebsiella pneumoniae from perspective of hospital so as to provide evidence-based guidance for assessment and optimization of bacterial resistance-related intervention policies.METHODS The medical data were collected from 170 874 patients who were discharged from a public three-A tertiary general hospital of a province in central part of China from 2018 to 2019.Among the enrolled patients,489 had ESBLs-producing K.pneumoniae infection and were assigned as the positive infection group,1 162 had non-ESBLs-producing K.pneumoniae infec-tion and were assigned as the negative infection group,and 169 223 patients had non-K.pneumomniae infection and were set as the non-infection group.The hazard ratio of death,extra hospitalization days and extra hospitaliza-tion cost that were induced by the ESBLs-producing K.pneumoniae infection were calculated by means of propen-sity score matching,Cox's proportional hazards regression model,multi-state model and cost-to-charge ratio.RESULTS By means of PSM,489 cases were included into the positive infection group,489 cases into the negative infection group,43 353 cases into the non-infection group.The positive infection patients were as 1.96 times the risk of death as the negative infection patients(P＜0.05).Set the negative infection group as the control,the in-fection did not increase the risk of death.Multi-state model analysis showed that the extra hospitalization days(due to the ESBLs-producing K.pneumoniae infection)of the positive infection group was 7.99 d/case as com-pared with the non-infection patients,4.01 days/case as compared with the negative infection patients;the extra hospitalization cost of the positive infection group was 14 226.34 yuan/case as compared with the non-infection pa-tients,7 139.88 yuan/case as compared with the negative infection patients.CONCLUSION The ESBLs-producing K.pneumoniae infection may increase the risk of death of the patients,extend the length of hospital stay and in-crease the hospitalization cost.It is necessary for the hospital to strengthen the surceillance of infection and drug resistance and optimize the relevant cost control.
Bacterial drug resistanceExtended-spectrum β-lactamases-producing Klebsiella pneumoniaeMulti-state modelPerspective from hospitalHealth burdenEconomic burden
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