Publication:
Excess burden of antibiotic-resistant bloodstream infections: evidence from a multicentre retrospective cohort study in Chile, 2018–2022

Simple item page
dc.contributor.authorAllel, Kasim
dc.contributor.authorPeters, Anne Sophie
dc.contributor.authorHaghparast-Bidgoli, Hassan
dc.contributor.authorSpencer-Sandino, Maria
dc.contributor.authorConejeros, Jose
dc.contributor.authorGarcia, Patricia
dc.contributor.authorPouwels, Koen B.
dc.contributor.authorYakob, Laith
dc.contributor.authorMunita, Jose M.
dc.contributor.authorUndurraga, Eduardo A.
dc.date.accessioned2024-12-11T15:47:19Z
dc.date.available2024-12-11T15:47:19Z
dc.date.issued2024
dc.description.abstractBackground Antibiotic-resistant bloodstream infections (ARB BSI) cause an enormous disease and economic burden. We assessed the impact of ARB BSI caused by high- and critical-priority pathogens in hospitalised Chilean patients compared to BSI caused by susceptible bacteria. Methods We conducted a retrospective cohort study from 2018 to 2022 in three Chilean hospitals and measured the association of ARB BSI with in-hospital mortality, length of hospitalisation (LOS), and intensive care unit (ICU) admission. We focused on BSI caused by Acinetobacter baumannii, Enterobacterales, Staphylococcus aureus, Enterococcus species, and Pseudomonas aeruginosa. We addressed confounding using propensity scores, inverse probability weighting, and multivariate regressions. We stratified by community- and hospital-acquired BSI and assessed total hospital and productivity costs. Findings We studied 1218 adult patients experiencing 1349 BSI episodes, with 47.3% attributed to ARB. Predominant pathogens were Staphylococcus aureus (33% Methicillin-resistant ‘MRSA’), Enterobacterales (50% Carbapenem-resistant ‘CRE’), and Pseudomonas aeruginosa (65% Carbapenem-resistant ‘CRPA’). Approximately 80% of BSI were hospital-acquired. ARB was associated with extended LOS (incidence risk ratio IRR = 1.14, 95% CI = 1.05–1.24), increased ICU admissions (odds ratio OR = 1.25; 1.07–1.46), and higher mortality (OR = 1.42, 1.20–1.68) following index blood culture across all BSI episodes. In-hospital mortality risk, adjusted for time-varying and fixed confounders, was 1.35-fold higher (1.16–1.58) for ARB patients, with higher hazard ratios for hospital-acquired MRSA and CRE at 1.37 and 1.48, respectively. Using a societal perspective and a 5% discount rate, we estimated excess costs for ARB at $12,600 per patient, with an estimated annual excess burden of 2270 disability-adjusted life years (DALYs) and $9.6 (5.0–16.4) million. Interpretation It is urgent to develop and implement interventions to reduce the burden of ARB BSIs, particularly from MRSA and CRE.
dc.description.versionVersión publicada
dc.format.extent15 p.
dc.identifier.citationKasim Allel, Anne Peters, Hassan Haghparast-Bidgoli, Maria Spencer-Sandino, Jose Conejeros, Patricia Garcia, Koen B. Pouwels, Laith Yakob, Jose M. Munita, Eduardo A. Undurraga, Excess burden of antibiotic-resistant bloodstream infections: evidence from a multicentre retrospective cohort study in Chile, 2018–2022, The Lancet Regional Health - Americas, Volume 40, 2024, 100943, ISSN 2667-193X, https://doi.org/10.1016/j.lana.2024.100943.
dc.identifier.doihttps://doi.org/10.1016/j.lana.2024.100943
dc.identifier.urihttps://hdl.handle.net/11447/9466
dc.language.isoen
dc.subjectAntibioticresistance
dc.subjectBloodstreaminfections
dc.subjectMRSA
dc.subjectCRE
dc.subjectDiseaseburden
dc.subjectMortality
dc.subjectLatinAmerica
dc.titleExcess burden of antibiotic-resistant bloodstream infections: evidence from a multicentre retrospective cohort study in Chile, 2018–2022
dc.typeArticle
dcterms.accessRightsAcceso abierto
dcterms.sourceThe Lancet Regional Health - Americas
dspace.entity.typePublication
relation.isAuthorOfPublication9aa6c0c0-19d6-4242-bf19-072f65ee8b0b
relation.isAuthorOfPublicationec52b0bf-d0bc-4844-9531-eca4a65f2b8e
relation.isAuthorOfPublication.latestForDiscovery9aa6c0c0-19d6-4242-bf19-072f65ee8b0b

Files

Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
1-s2.0-S2667193X24002709-main.pdf
Size:
645.81 KB
Format:
Adobe Portable Document Format
Download
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
347 B
Format:
Item-specific license agreed upon to submission
Description:
Download

Collections

Artículos Medicina y Ciencias de la Salud

Implementado por OpenGeek Services