Apostolopoulou Eleni
Background: Bloodstream infections relate to significant morbidity and mortality in critically ill patients, despite the expanded availability of broad spectrum antibiotics and advances in supportive care. The aim of this study was to determine the crude excess mortality, the length of stay and the cost of antibiotics of patients with BSIs Bloodstream infections. Method and material: A prospective descriptive study was conducted from January to December 2010. Patient data included demographic characteristics, disease severity, evaluated with the Acute Physiology and Chronic Health Evaluation II score on admission, co-morbidity evaluated with the weighted Charlson co-morbidity index on admission, date of Bloodstream infection BSI onset, duration of central lines, type and duration of the administrated antibiotics. Results: The incidence of Bloodstream infection was 29% and the incidence density was 14.9 cases/1000 patient days. The crude attributable mortality was 33.7% among patients with Bloodstream infection. The crude attributable length of stay was 10 days among patients with Bloodstream infection and reached 44 days in patients with Bloodstream infection &Ventilator associated pneumonia & Catheter associated-Urinary Tract Infection. The crude attributable antibiotics cost was 1208€ among patients with Bloodstream infection and reached 6533€ in patients with Bloodstream infection &Ventilator associated pneumonia & Catheter associated-Urinary Tract Infection, while in patients with Bloodstream infection caused by Carbapenem Resistant GRAM negative pathogens and no Carbapenem Resistant GRAM negative pathogens was 2760€ and 1896€, respectively. The overall excess antibiotic cost among patients with Bloodstream infection was 3463.48€ per case. Because as many as 65%-70% of cases of Bloodstream infection are preventable the overall antibiotic cost attributable to Bloodstream infection (170.769,72€) could have been reduced considerably. Conclusion: Our study suggests that the price of Bloodstream infection is considerable and that neither patients, tax payers, nor hospitals benefit. The successful implementation of infection prevention and control programs and quality improvement initiatives would not only significantly reduce patient mortality but also result in considerable cost saving and reduce length of stay.
