碳青霉烯类耐药与敏感鲍曼不动杆菌医院感染经济损失的差异

目的了解碳青霉烯类耐药与敏感鲍曼不动杆菌医院感染经济损失的差异,提高临床医务人员对耐碳青霉烯类鲍曼不动杆菌(CRAB)感染防控的认识。方法以某三甲医院2012年10月—2018年9月重症医学科(ICU)鲍曼不动杆菌感染患者为研究对象,依据其感染的鲍曼不动杆菌对碳青霉烯类敏感结果分为CRAB组和碳青霉烯类敏感鲍曼不动杆菌(CSAB)组,将两组患者按照配对标准1∶1配对,采用配对秩和检验分析两组患者的直接经济损失。结果最终匹配成功46对,CRAB组住院总费用中位数为179 192元,CSAB组为82 314元,两组差值为96 878元;CRAB组住院日数中位数为49 d,CSAB组为27 d,两组差值为22 d;两组患者住院总费用、住院日数比较,差异均有统计学意义(均P0.05)。CRAB医院感染患者直接经济损失的主要组成部分是西药费(29 246元)、材料费(19 465元)和治疗费(12 872元),占直接经济损失费用的63.6%。结论 CRAB医院感染导致患者住院日数延长,住院费用增加,因此降低CRAB医院感染发生率至关重要。

Difference in economic loss between carbapenem-resistant Acinetobacter baumannii and carbapenem-susceptible Acinetobacter baumannii healthcare-associated infection

Objective To understand the difference in economic loss between carbapenem-resistant Acinetobacter baumannii(CRAB) and carbapenem-susceptible Acinetobacter baumannii(CSAB) healthcare-associated infection(HAI), and improve health care workers' awareness on the prevention and control of CRAB infection. Methods Patients with Acinetobacter baumannii infection in the intensive acre unit(ICU) of a tertiary first-class hospital from October 2012 to September 2018 were studied and divided into CRAB group and CSAB group according to susceptibility of Acinetobacter baumannii to carbapenems, two groups were matched according to 1:1 matching standard, paired rank sum test was used to analyze the direct economic loss of two groups of patients. Results Forty-six pairs were matched, the median hospitalization expense of CRAB group and CSAB were 179 192 yuan and 82 314 yuan respectively, difference between two groups was 96 878 yuan; the median length of hospital stay of CRAB group and CSAB group were 49 days and 27 days respectively, difference between two groups was 22 days; difference in total hospitalization expense and length of hospital stay between two groups were both significant (both P<0.05). The main direct economic loss of patients with CRAB HAI were western medicine fee (29 246 yuan), material fee (19 465 yuan) and treatment fee (12 872 yuan), accounting for 63.6% of direct economic loss. Conclusion CRAB HAI can lead to prolonged length of hospital stay and increase hospitalization expense, so it is essential to reduce the incidence of CRAB HAI.