Clinical and economic burden of community-onset multidrug-resistant infections requiring hospitalization

Mostra el registre complet Registre parcial de l'ítem

• dc.contributor.author López Montesinos, Inmaculada
• dc.contributor.author Domínguez-Guasch, A.
• dc.contributor.author Gómez-Zorrilla, Silvia
• dc.contributor.author Duran Jordà, Xavier, 1974-
• dc.contributor.author Siverio, Ana
• dc.contributor.author Arenas-Miras, María Del Mar
• dc.contributor.author Montero, Maria Milagro
• dc.contributor.author Sorli Redó, M. Luisa
• dc.contributor.author Grau Cerrato, Santiago
• dc.contributor.author Horcajada Gallego, Juan Pablo
• dc.date.accessioned 2021-04-12T07:05:01Z
• dc.date.available 2021-04-12T07:05:01Z
• dc.date.issued 2020
• dc.description.abstract Objectives: To analyze the clinical and economic burden of community-acquired (CA) or community-onset healthcare-associated (COHCA) multidrug-resistant (MDR) infections requiring hospitalization. Methods: Case-control study. Adults admitted with CA or COHCA MDR infections were considered cases, while those admitted in the same period with non-MDR infections were controls. The matching criteria were source of infection and/or microorganism. Primary outcome was 30-day clinical failure. Secondary outcomes were 90-day and 1-year mortality, hospitalization costs and resource consumption. Results: 194 patients (97 cases and 97 controls) were included. Multivariate analysis identified age (odds ratio [OR], 1.07, 95% confidence interval [CI], 1.01-1.14) and SOFA score (OR, 1.45, CI95%, 1.15-1.84) as independent predictors of 30-day clinical failure. Age (hazard ratio [HR] 1.09, 95%CI, 1.03-1.16) was the only factor associated with 90-day mortality, whereas age (HR 1.06, 95%CI, 1.03-1.09) and Charlson Index (HR 1.2, 95%CI, 1.07-1.34) were associated with 1-year mortality. MDR group showed longer hospitalization (p<0.001) and MDR hospitalization costs almost doubled those in the non-MDR group. MDR infections were associated with higher antimicrobial costs. Conclusions: Worse economic outcomes were identified with community-onset MDR infections. MDR was associated with worse clinical outcomes but mainly due to higher comorbidity of patients in MDR group, rather than multidrug resistance.
• dc.format.mimetype application/pdf
• dc.identifier.citation López-Montesinos I, Domínguez-Guasch A, Gómez-Zorrilla S, Duran-Jordà X, Siverio-Parès A, Arenas-Miras MM, et al. Clinical and economic burden of community-onset multidrug-resistant infections requiring hospitalization. J Infect. 2020 Mar; 80(3): 271-8. DOI: 10.1016/j.jinf.2019.12.021
• dc.identifier.doi http://dx.doi.org/10.1016/j.jinf.2019.12.021
• dc.identifier.issn 0163-4453
• dc.identifier.uri http://hdl.handle.net/10230/47082
• dc.language.iso eng
• dc.publisher Elsevier
• dc.rights © Elsevier http://dx.doi.org/10.1016/j.jinf.2019.12.021
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.subject.keyword Burden
• dc.subject.keyword Clinical failure
• dc.subject.keyword Community-onset healthcare-associated infections
• dc.subject.keyword Community-onset infections
• dc.subject.keyword Hospital costs
• dc.subject.keyword Mortality
• dc.subject.keyword Multidrug resistance
• dc.subject.keyword Resource consumption
• dc.title Clinical and economic burden of community-onset multidrug-resistant infections requiring hospitalization
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/acceptedVersion