Economic burden of antibiotic treatment of healthcare-associated infections at a tertiary care hospital ICU in Goa, India

2016 ◽  
Vol 47 (3) ◽  
pp. 197-201 ◽  
Author(s):  
Devika D Misal ◽  
Saleel V Maulingkar ◽  
Sushma Bhonsle

Antibiotics to treat healthcare-associated infections (HCAIs) contribute to a substantial proportion of drug expenditure in intensive care units (ICUs). Our study aimed to determine the common HCAIs in our hospital ICU, to assess the antibiotics prescribed and the mean antibiotic cost per HCAI. All adult patients, admitted to the ICU over a 1-year period, were included in the study. HCAIs were determined according to CDC definition. The incidence of HCAIs in the ICU was 16%. Ventilator associated pneumonia (50%) was the most common HCAI, followed by urinary tract infection (35.6%). The total cost of antibiotic treatment for HCAIs in ICU over a 1-year period was approximately Rs. 2 million (US$32,000); the mean antibiotic cost per HCAI was calculated as Rs. 17,000 (US$255). HCAIs in the ICU thus put a significant economic burden on the patient and the healthcare network and should be prevented by implementing recommended infection control guidelines.

2013 ◽  
Vol 7 (2) ◽  
pp. 06-12
Author(s):  
Zahidul Hasan ◽  
Md. Kamrul Islam ◽  
Arifa Hossain

Recently non-fermenting Gram negative rods (NFGNR) are playing an important role in healthcare associated infections. This observational study in a tertiary care hospital of Dhaka city conducted during 01August 2007 to 30 June 2013 found that 34.8% isolated organisms from patients with healthcare associated infections were NFGNR. Majority (74.3 %) of these infections were occurring inside critical care areas. Pseudomonas and Acinetobacter together constituted 79.6% of the total NFGNR whereas Burkholderia cephacia complex (15.4%), Stenotrophomonas (4.3%) and Chryseobacterium species (0.7%) combined constituted remaining 20.4%. Out of total NFGNRs, Pseudomonas was responsible for highest number of catheter associated urinary tract infections (55.6%), ventilator associated pneumonia (46.3%), respiratory tract infection (65.8%) and surgical site infection (70.6%). Blood stream infection was predominantly caused by Burkholderia cephacia complex (33.5%) and Acinetobacter spp. (39.5%). Other than colistin most of the organisms were resistant to antibiotics commonly recommended for NFGNR.DOI: http://dx.doi.org/10.3329/bjmm.v7i2.19326 Bangladesh J Med Microbiol 2013; 07(02): 6-12


Author(s):  
SARALA KS ◽  
NANDAKUMAR BS ◽  
NARENDRANATH V

Objective: Microorganisms are minute and can be only in microscope and these are not visible to naked eyes. Various types of microbe include bacteria, virus, fungi, and protozoa. These microorganisms are subclassified and these are disease causing leading to mortality and morbidity. Healthcare-associated infections (HAIs) arise from different variants of microbes and knowing the category of microbes for treating the diseases with specific antibiotics is important for better patient outcome. Methods: Using secondary data, all the patients who had HAI for 3 years were taken into consideration by considering the different variants of microorganisms. Results: Retrospective data collected for the period of 3 years the inpatients who got admitted for more than 48 h of duration, the data collected included the parameters for various microorganisms such as Bacilli, cocci, Klebsiella, Acinetobacter, and Aures, other micro-organisms such as Escherichia coli, Citrobacter, and Pseudomonas microorganisms. Bacilli group of microorganisms was more common for urinary tract infection, blood stream infection, and ventilator-associated pneumonia. Aures was more common among surgical site infection infections. Conclusions: Most of the patients who had an HAI had two or more different kind of microorganisms which are responsible for spreading infection. There is a need to control microbial flora in the hospital set up as the rate of HAI increases with microbial flora.


2020 ◽  
Vol 1 (1) ◽  
pp. 18-22
Author(s):  
Muhammad Labeeq ◽  
Muhammad Ahsan Tariq ◽  
Samra Atta Tung ◽  
Muhammad Asfand Yar ◽  
Waleed Rehman ◽  
...  

Background: Among the various complications of diabetes, lower-extremity amputation due to diabetic foot is a common problem. In Pakistan, 6-7% of patients with diabetes suffer from diabetic foot ulceration. Objectives: Our primary objective was to explore the frequency of diabetic foot amputations, and the secondary objective was to calculate the economic burden of these preventable surgeries on the health budget of the provincial government. Materials & Methods: It was a retrospective cross-sectional observational study conducted after obtaining approval from the Ethical Review Committee of Allied hospital, Faisalabad Medical University. The data of diabetic foot patients who underwent amputations between July 2017 and December 2017 were retrieved from three Surgical Units (I, II & III), using a purposive sampling technique. All amputations carried out for reasons other than diabetic foot were excluded. The direct medical cost of one diabetic foot amputation was calculated via a local survey of the various private hospitals of Faisalabad. The indirect costs in terms of loss of productivity and disability costs, transport costs, rehabilitation costs were not included in this study. The data were evaluated by using SPSS Version 23. Results: A total of 85 patients were included in our study. The male to female ratio was 2.7 to 1. The mean direct treatment cost for minor amputation was PKR 46926.00 ± 11730.90 ($382.35 ± 95.58), and the mean direct treatment cost for major amputation was PKR 53720.00 ± 12401.24 ($437.71 ± 101.40). Out of 85 amputations, 63 (74%) were major amputations, and the remaining 22 (26%) were minor amputations. The total cost for 63 major amputations was PKR 3,384,360 ($27568.91) and for 22 minor amputation was PKR 1,032,372 ($8409.67). The net cost came out to be PKR 4,416,732 ($35978.59) for all the 85 cases being reported in a tertiary care hospital of Faisalabad for six months. Conclusion: Diabetic foot, a preventable complication of long-term diabetes mellitus, has an economic burden on the hospital budget, which, if adequately addressed via primary prevention programme, can yield not just economical but medical benefits as well.


2007 ◽  
Vol 28 (12) ◽  
pp. 1361-1366 ◽  
Author(s):  
David J. Weber ◽  
Emily E. Sickbert-Bennett ◽  
Vickie Brown ◽  
William A. Rutala

Objectives.To assess the surveillance coverage obtained with Centers for Disease Control and Prevention (CDC)-recommended surveillance of healthcare-associated infections (HAIs), which is focused on intensive care units (ICUs) and emphasizes device-related infections (ie, those associated with central venous catheters, ventilators, and/or urinary catheters), compared with the surveillance coverage achieved by comprehensive hospitalwide surveillance. In addition, we assessed whether the infection rates in step-down units more resemble those in wards or ICUs.Methods.Review of prospectively obtained, comprehensive hospitalwide surveillance data from 2004 through 2005 for an acute care tertiary care hospital with approximately 700 beds. Surveillance data was obtained by trained infection control professionals using standard CDC criteria for HAIs.Results.CDC-recommended ICU surveillance for catheter-related bloodstream infection (BSI) and ventilator-associated pneumonia would have detected only 87 (21.4%) of 407 catheter-related BSIs and only 66 (37.9%) of 174 respiratory tract infections that occurred in the medical and surgical services. Only 31 (34.8%) of 89 infections caused by methicillin-resistant Staphylococcus aureus and 7 (31.8%) of 22 infections caused by vancomycin-resistant Enterococcus occurred in our adult ICUs.Conclusions.Rates of HAIs were highest in the ICUs, intermediate in step-down units, and lowest in the wards. The rates of infections in the step-down units were more similar to those in the wards than to those in the ICUs. To prevent HAIs, more comprehensive surveillance may be indicated.


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