ISSN: 2149-2247 | E-ISSN: 2149-2549

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Erciyes Medical Journal Economic Burden of Multidrug-Resistant Gram-Negative Infections in a Developing Country [Erciyes Med J]
Erciyes Med J. 2019; 41(3): 312-315 | DOI: 10.14744/etd.2019.43179

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

Aysegul Ulu Kılıç1, Gamze Kalin Unuvar1, Fatma Cevahir2, Emine Alp3
1Department of Infectious Diseases, Erciyes University Faculty of Medicine, Kayseri, Turkey
2Infection Control Committee, Erciyes University Faculty of Medicine, Kayseri, Turkey
3Republic of Turkey, Ministry of Health, Ankara, Turkey

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<0.01). Also, a total hospital cost for patients was significantly higher in the case group ($8,895 [2,621–23,883] and $6,551 [1,441–20,425], respectively) (p<0.05).
Conclusion: Patients with a high APACHE II score transferred from another hospital and who use an antibiotic before the ICU infection and arterial catheter are at a greater risk of MDR-GN infections. Also, the infections pose a significant burden on health care facilities due to more prolonged and costly treatments.

Keywords: Economic burden, gram negatives, developing country

Aysegul Ulu Kılıç, Gamze Kalin Unuvar, Fatma Cevahir, Emine Alp. Economic Burden of Multidrug-Resistant Gram-Negative Infections in a Developing Country. Erciyes Med J. 2019; 41(3): 312-315

Corresponding Author: Aysegul Ulu Kılıç, Türkiye
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