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Author  |
Meng, X.; Liu, S.; Duan, J.; Huang, X.; Zhou, P.; Xiong, X.; Gong, R.; Zhang, Y.; Liu, Y.; Fu, C.; Li, C.; Wu, A. |
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Title |
Risk factors and medical costs for healthcare-associated carbapenem-resistant Escherichia coli infection among hospitalized patients in a Chinese teaching hospital |
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Journal Article |
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Year |
2017 |
Publication |
BMC Infectious Diseases |
Abbreviated Journal |
BMC Infect Dis |
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17 |
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1 |
Pages |
82 |
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Keywords |
Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents/economics/therapeutic use; Anti-Infective Agents; *Carbapenems; Case-Control Studies; Catheterization, Central Venous/statistics & numerical data; Child; Child, Preschool; China/epidemiology; Cross Infection/drug therapy/economics/*epidemiology/microbiology; Drug Costs; *Drug Resistance, Bacterial; Escherichia coli Infections/drug therapy/economics/*epidemiology/microbiology; Female; Health Care Costs; Hemoglobins; Hospitals, Teaching; Humans; Hyperglycemia/epidemiology; Incidence; Infant; Infant, Newborn; Length of Stay/*statistics & numerical data; Logistic Models; Male; Middle Aged; Multivariate Analysis; Retrospective Studies; Risk Factors; Tertiary Care Centers; Tracheostomy/statistics & numerical data; Urologic Diseases/epidemiology; Young Adult; Crec; Csec; Healthcare-associated infection; Risk factors |
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Abstract |
BACKGROUND: The emergence and spread of Carbapenem-resistant Escherichia coli (CREC) is becoming a serious problem in Chinese hospitals, however, the data on this is scarce. Therefore, we investigate the risk factors for healthcare-associated CREC infection and study the incidence, antibiotic resistance and medical costs of CREC infections in our hospital. METHODS: We conducted a retrospective, matched case-control-control, parallel study in a tertiary teaching hospital. Patients admitted between January 2012 and December 2015 were included in this study. For patients with healthcare-associated CREC infection, two matched subject groups were created; one group with healthcare-associated CSEC infection and the other group without infection. RESULTS: Multivariate conditional logistic regression analysis demonstrated that prior hospital stay (<6 months) (OR:3.96; 95%CI:1.26-12.42), tracheostomy (OR:2.24; 95%CI: 1.14-4.38), central venous catheter insertion (OR: 8.15; 95%CI: 2.31-28.72), carbapenem exposure (OR: 12.02; 95%CI: 1.52-95.4), urinary system disease (OR: 16.69; 95%CI: 3.01-89.76), low hemoglobin (OR: 2.83; 95%CI: 1.46-5.50), and high blood glucose are associated (OR: 7.01; 95%CI: 1.89-26.02) with CREC infection. Total costs (p = 0.00), medical examination costs (p = 0.00), medical test costs (p = 0.00), total drug costs (p = 0.00) and ant-infective drug costs (p = 0.00) for the CREC group were significantly higher than those for the no infection group. Medical examination costs (p = 0.03), total drug costs (p = 0.03), and anti-infective drug costs (p = 0.01) for the CREC group were significantly higher than for the CSEC group. Mortality in CREC group was significantly higher than the CSEC group (p = 0.01) and no infection group (p = 0.01). CONCLUSION: Many factors were discovered for acquisition of healthcare-associated CREC infection. CREC isolates were resistant to most antibiotics, and had some association with high financial burden and increased mortality. |
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Address |
Infection Control Centre, Xiangya Hospital of Central South University, Changsha, China. xywuanhua@csu.edu.cn |
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Language |
English |
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ISSN |
1471-2334 |
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Notes |
PMID:28095785 |
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Call Number |
ref @ user @ |
Serial |
99123 |
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