The impact of imipenem-resistant Acinetobacter baumannii infection on clinical outcomes and medical care costs / 中华传染病杂志

ABSTRACT

ObjectiveTo investigate the impact of antimicrobial resistance on clinical outcomes and medical care costs among patients with imipenem-resistant Acinetobacter baumannii (IRAB) nosocomial infection.MethodsA retrospective matched case-control study was performed to compare the differences of clinical outcomes and medical care costs between patients with IRAB infection and patients with imipenem-susceptive Acinetobacter baumannii (ISAB) infection in a tertiary care university teaching hospital in China from January 2007 to June 2009.Cases were matched to controls with ratio of 1:1 on the basis of age,sex,severity of underlying diseases,source of infection,duration of hospitalization period and length of hospital stay before onset of infection.The measurement data between groups were compared by t test and rank test.The numeration data between groups were compared by x2 test. Multiple analysis was performed by Logistic regression.ResultsThe total mortality rate of IRAB infection patients was significantly higher than that of ISAB infection patients (39.1％ vs 20.3 ％ ; x2 =11.728,P＜0.01).Among 138 pairs of patients in IRAB group and ISAB group,there were 72 matched case-control pairs survived,which were significantly different in length of total hospital stay (28.5 days vs 23.0 days; x2 =2.886,P＜0.01) and intensive care unit (ICU) stay (14.5 days vs 0 day; x2 =4.844,P＜0.01).For all the 138 case-control pairs,everyday total hospitalization cost and everyday antibiotic therapy cost in IRAB cases were both higher than ISAB controls (RMB 3652 yuan vs RMB 2092 yuan; Z=3.792,P＜0.01 and RMB 555 yuan vs RMB 338 yuan; Z=4.209,P＜0.01).ConclusionIRAB infection can increase the mortality rate,lengthen hospital stay and elevate the medical costs notably.