Health and economic burden of antimicrobial-resistant infections in Australian hospitals: a population-based model

Infect Control Hosp Epidemiol. 2019 Mar;40(3):320-327. doi: 10.1017/ice.2019.2.

Abstract

Objective: To estimate the additional health and economic burden of antimicrobial-resistant (AMR) infections in Australian hospitals.

Methods: A simulation model based on existing evidence was developed to assess the additional mortality and costs of healthcare-associated AMR Escherichia coli (E. coli), Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterococcus faecium, and Staphylococcus aureus infections.

Setting: Australian public hospitals.

Findings: Australian hospitals spent an additional AUD$5.8 million (95% uncertainty interval [UI], $2.2-$11.2 million) per year treating ceftriaxone-resistant E.coli bloodstream infections (BSI), and an estimated AUD$5.5 million per year (95% UI, $339,633-$22.7 million) treating MRSA patients. There are no reliable estimates of excess morbidity and mortality from AMR infections in sites other than the blood and in particular for highly prevalent AMR E. coli causing urinary tract infections (UTIs).

Conclusion: The limited evidence-base of the health impact of resistant infection in UTIs limits economic studies estimating the overall burden of AMR. Such data are increasingly important and are urgently needed to support local clinical practice as well as national and global efforts to curb the spread of AMR.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Australia
  • Computer Simulation / statistics & numerical data
  • Cost of Illness
  • Cross Infection* / epidemiology
  • Cross Infection* / mortality
  • Drug Resistance, Multiple, Bacterial / drug effects
  • Enterococcus / drug effects
  • Enterococcus faecium / drug effects
  • Escherichia coli Infections / drug therapy
  • Female
  • Gram-Positive Bacterial Infections / drug therapy
  • Hospitals / statistics & numerical data
  • Humans
  • Klebsiella Infections / drug therapy
  • Male
  • Pseudomonas Infections / drug therapy
  • Staphylococcal Infections / drug therapy
  • Urinary Tract Infections / drug therapy

Substances

  • Anti-Bacterial Agents

Supplementary concepts

  • Enterococcus inusitatus