Abstract：
The socioeconomic and clinical burden of multidrug-resistant organisms (MDRO), including methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), multidrug-resistant Acinetobacter baumannii (MRAB), multidrug-resistant Pseudomonas aeruginosa (MRPA), and carbapenem-resistant Enterobacteriaceae (CRE) have not yet been adequately addressed.
We prospectively searched for MDRO bacteremia cases with matched controls from 10 hospitals across Korea during a 6-month period in 2017. Patients were classified into the MDRO, susceptible organism, and no-infection groups. The corresponding susceptible or no-infection controls had been selected according to predefined criteria. We collected clinical information and estimated the total additional medical cost due to MDRO infections using the multistate model.
During the 6-month period, a total of 486 MDRO bacteremia cases (260, 87, 18, 20, and 101 cases of MRSA, MRAB, MRPA, CRE, and VRE, respectively) were identified. The 90-d mortality rates were 30.4%, 63.2%, 16.7%, 55.0%, and 47.5%, respectively. The additional costs caused by bacteremia were $15 768, $35 682, $39 908, $72 051, and $33 662 per MDRO type, respectively. Based on these 6-month data, the estimated annual number of bacteremia cases due to these five MDRO in Korea were 7979 (4070, 1396, 218, 461, and 1834 cases, respectively). Overall, this caused an estimated 3280 (1237, 882, 36, 254, and 871, respectively) deaths and cost $294 505 002 ($84 707 359, $74 387 364, $10 344 370, $45 850 215, and $79 215 694, respectively) (range $170,627,020-$416,094,679) in socioeconomic loss.
A tremendous clinical and economic burden is caused by MDRO bacteremia compared with antibiotic-susceptible and no-infection groups. Substantial investment and efforts by related government agencies and medical staffs are needed.
We prospectively searched for MDRO bacteremia cases with matched controls from 10 hospitals across Korea during a 6-month period in 2017. Patients were classified into the MDRO, susceptible organism, and no-infection groups. The corresponding susceptible or no-infection controls had been selected according to predefined criteria. We collected clinical information and estimated the total additional medical cost due to MDRO infections using the multistate model.
During the 6-month period, a total of 486 MDRO bacteremia cases (260, 87, 18, 20, and 101 cases of MRSA, MRAB, MRPA, CRE, and VRE, respectively) were identified. The 90-d mortality rates were 30.4%, 63.2%, 16.7%, 55.0%, and 47.5%, respectively. The additional costs caused by bacteremia were $15 768, $35 682, $39 908, $72 051, and $33 662 per MDRO type, respectively. Based on these 6-month data, the estimated annual number of bacteremia cases due to these five MDRO in Korea were 7979 (4070, 1396, 218, 461, and 1834 cases, respectively). Overall, this caused an estimated 3280 (1237, 882, 36, 254, and 871, respectively) deaths and cost $294 505 002 ($84 707 359, $74 387 364, $10 344 370, $45 850 215, and $79 215 694, respectively) (range $170,627,020-$416,094,679) in socioeconomic loss.
A tremendous clinical and economic burden is caused by MDRO bacteremia compared with antibiotic-susceptible and no-infection groups. Substantial investment and efforts by related government agencies and medical staffs are needed.
摘要：
目的：多药耐药菌（MDRO）的社会经济和临床负担，包括耐甲氧西林金黄色葡萄球菌（MRSA），耐万古霉素肠球菌(VRE),多重耐药鲍曼不动杆菌（MRAB），多药耐药铜绿假单胞菌(MRPA),和碳青霉烯类耐药肠杆菌（CRE）尚未得到充分解决。
方法：我们在2017年的6个月期间，从韩国的10家医院前瞻性地搜索了具有匹配对照的MDRO菌血症病例。患者被分类为MDRO，易感生物，和无感染组。已根据预定标准选择了相应的易感或无感染对照。我们收集了临床信息，并使用多态模型估算了由于MDRO感染引起的总额外医疗费用。
结果：在6个月期间，共486例MDRO菌血症(260、87、18、20和101例MRSA，MRAB,MRPA,CRE,和VRE,分别)被确定。90d死亡率为30.4%,63.2%,16.7%,55.0%,和47.5%，分别。每个MDRO类型的菌血症引起的额外费用为$15768，$35682，$39908，$72051和$33662，分别。根据这些6个月的数据，在韩国，由于这五个MDRO引起的菌血症病例的估计年度数量为7979例（4070、1396、218、461和1834例，分别)。总的来说,这造成约3280人(分别为1237、882、36、254和871人)死亡,并造成社会经济损失$294505002(分别为$84707359、$74387364、$10344370、$45850215和$79215694)(范围$170,627,020-$416,094,679)。
结论：与抗生素敏感和非感染组相比，MDRO菌血症造成了巨大的临床和经济负担。需要相关政府机构和医务人员的大量投资和努力。
方法：我们在2017年的6个月期间，从韩国的10家医院前瞻性地搜索了具有匹配对照的MDRO菌血症病例。患者被分类为MDRO，易感生物，和无感染组。已根据预定标准选择了相应的易感或无感染对照。我们收集了临床信息，并使用多态模型估算了由于MDRO感染引起的总额外医疗费用。
结果：在6个月期间，共486例MDRO菌血症(260、87、18、20和101例MRSA，MRAB,MRPA,CRE,和VRE,分别)被确定。90d死亡率为30.4%,63.2%,16.7%,55.0%,和47.5%，分别。每个MDRO类型的菌血症引起的额外费用为$15768，$35682，$39908，$72051和$33662，分别。根据这些6个月的数据，在韩国，由于这五个MDRO引起的菌血症病例的估计年度数量为7979例（4070、1396、218、461和1834例，分别)。总的来说,这造成约3280人(分别为1237、882、36、254和871人)死亡,并造成社会经济损失$294505002(分别为$84707359、$74387364、$10344370、$45850215和$79215694)(范围$170,627,020-$416,094,679)。
结论：与抗生素敏感和非感染组相比，MDRO菌血症造成了巨大的临床和经济负担。需要相关政府机构和医务人员的大量投资和努力。
