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Healthcare resource utilization and costs associated with inadequate initial antibiotic treatment of bacteraemia produced by carbapenem-resistant Gram-negative bacilli (CRGNB): a descriptive, observational study in Spanish hospitals.

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Title: Healthcare resource utilization and costs associated with inadequate initial antibiotic treatment of bacteraemia produced by carbapenem-resistant Gram-negative bacilli (CRGNB): a descriptive, observational study in Spanish hospitals.
Alternate Title: Utilización de recursos sanitarios y costes asociados al tratamiento antibiótico inicial inadecuado de la bacteriemia producida por bacilos gramnegativos resistentes a carbapenémicos: un estudio observacional descriptivo en hospitales españoles
Authors: Garnacho-Montero, José1, María Aguado, José2,3, Alemparte, Enrique4, Horcajada, Juan P.3,5, López-Medrano, Francisco2,3, Ramírez, Paula6, Giró-Perafita, Ariadna7 agiro@omakaseconsulting.com, Blasco, Martí7, Suberviola, Borja8
Source: Revista Española de Quimioterapia. jun2025, Vol. 38 Issue 3, p197-207. 11p.
Subjects: NOSOCOMIAL infections, HOSPITAL wards, GRAM-negative bacteria, PUBLIC hospitals, BACTEREMIA, GUARDIAN & ward
Abstract (English): Introduction: Carbapenem-resistant gram-negative bacilli (CRGNB) are one of the main causes of nosocomial infections, posing a major public health challenge. Blood stream infections (BSI) require special attention because of the higher morbidity and mortality associated. Objective: To assess the impact of initial adequate or inadequate antibiotic treatment on the length of stay (LOS) and healthcare resource utilisation of patients with bloodstream infections (BSI) caused by a Carbapenem-resistant gram-negative bacilli (CRGNB) in the Spanish clinical practice. Methods: A descriptive, observational, retrospective chart review study of patients diagnosed with CRGNB bacteriemia in 6 Spanish public hospitals. Results: The overall median LOS of the total population (n=64) was 26.5 days (Q1: 16 days; Q3: 40 days). The median LOS for the initially adequately treated group was 27 days (Q1: 17; Q3: 50), and 24 days (Q1: 15; Q3: 38) for the initially inadequately treated (t-test p= 0.5031). In the Hospital Ward group (n=44), initially adequately treated patients spent hospitalised a median of 6 days less than the initially inadequately treated patients (18 days [Q1: 12; Q3: 27] vs 24 days [Q1: 15; Q3: 38] respectively, p=0.0269). In the total population analysis, initially adequately treated patients had a lower use of resources (20,895.02 € [Q1: 11,543.67 €; Q3: 61,773.17 €]) compared to initially inadequately treated patients (24,444.02 € [Q1: 11,571.63 €; Q3: 40,790.64 €). Conclusion: Results suggest that inadequate empirical treatment for BSI caused by CRGNB in the hospital ward could be associated with an increase in the LOS and resource utilization of these patients. [ABSTRACT FROM AUTHOR]
Abstract (Spanish): Introducción: Los bacilos gramnegativos resistentes a carbapenémicos (BGNRC) son una de las principales causas de infecciones nosocomiales, lo que supone un importante reto para la salud pública. Las infecciones del torrente sanguíneo (BSI) requieren especial atención por la mayor morbimortalidad asociada. Objetivo: Evaluar el impacto del tratamiento antibiótico inicial adecuado o inadecuado sobre la duración de la estancia hospitalaria (LOS) y la utilización de recursos sanitarios de los pacientes con infecciones del torrente sanguíneo (BSI) causada por bacilos gramnegativos resistentes a carbapenémicos (BGNRC) en la práctica clínica española. Material y métodos: Estudio descriptivo, observacional, retrospectivo de revisión de historias clínicas de pacientes diagnosticados de BSI por BGNRC en 6 hospitales públicos españoles. Resultados: La mediana global de la LOS de la población total (n=64) fue de 26,5 días (Q1: 16 días; Q3: 40 días). La mediana de LOS para el grupo tratado inicialmente de forma adecuada fue de 27 días (Q1: 17; Q3: 50), y de 24 días (Q1: 15; Q3: 38) para el grupo tratado inicialmente de forma inadecuada (t-test p= 0,5031). En el grupo de Planta (n=44), los pacientes tratados inicialmente de forma adecuada pasaron hospitalizados una mediana de 6 días menos que los pacientes tratados inicialmente de forma inadecuada (18 días [Q1: 12; Q3: 27] frente a 24 días [Q1: 15; Q3: 38] respectivamente, p=0,0269). En el análisis de la población total, los pacientes tratados inicialmente de forma adecuada tuvieron un menor uso de recursos (20.895,02 € [Q1: 11.543,67 €; Q3: 61.773,17 €]) en comparación con los pacientes tratados inicialmente de forma inadecuada (24.444,02 € [Q1: 11.571,63 €; Q3: 40.790,64 €). Conclusiones: Los resultados sugieren que el tratamiento empírico inadecuado de las BSI causadas por CRGNB en la planta de hospitalización podría estar asociado a un aumento de la estancia hospitalaria y de la utilización de recursos de estos pacientes. [ABSTRACT FROM AUTHOR]
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Database: MedicLatina
Description
Abstract:Introduction: Carbapenem-resistant gram-negative bacilli (CRGNB) are one of the main causes of nosocomial infections, posing a major public health challenge. Blood stream infections (BSI) require special attention because of the higher morbidity and mortality associated. Objective: To assess the impact of initial adequate or inadequate antibiotic treatment on the length of stay (LOS) and healthcare resource utilisation of patients with bloodstream infections (BSI) caused by a Carbapenem-resistant gram-negative bacilli (CRGNB) in the Spanish clinical practice. Methods: A descriptive, observational, retrospective chart review study of patients diagnosed with CRGNB bacteriemia in 6 Spanish public hospitals. Results: The overall median LOS of the total population (n=64) was 26.5 days (Q1: 16 days; Q3: 40 days). The median LOS for the initially adequately treated group was 27 days (Q1: 17; Q3: 50), and 24 days (Q1: 15; Q3: 38) for the initially inadequately treated (t-test p= 0.5031). In the Hospital Ward group (n=44), initially adequately treated patients spent hospitalised a median of 6 days less than the initially inadequately treated patients (18 days [Q1: 12; Q3: 27] vs 24 days [Q1: 15; Q3: 38] respectively, p=0.0269). In the total population analysis, initially adequately treated patients had a lower use of resources (20,895.02 € [Q1: 11,543.67 €; Q3: 61,773.17 €]) compared to initially inadequately treated patients (24,444.02 € [Q1: 11,571.63 €; Q3: 40,790.64 €). Conclusion: Results suggest that inadequate empirical treatment for BSI caused by CRGNB in the hospital ward could be associated with an increase in the LOS and resource utilization of these patients. [ABSTRACT FROM AUTHOR]
ISSN:02143429
DOI:10.37201/req/121.2024