Attributable Cost and Length of Stay Associated with Nosocomial Gram-Negative Bacterial Cultures

Antimicrobial Agents and Chemotherapy
Richard E NelsonMatthew H Samore

Abstract

Few studies have estimated the excess inpatient costs due to nosocomial cultures of Gram-negative bacteria (GNB), and those that do are often subject to time-dependent bias. Our objective was to generate estimates of the attributable costs of the underlying infections associated with nosocomial cultures by using a unique inpatient cost data set from the U.S. Department of Veterans Affairs that allowed us to reduce time-dependent bias. Our study included data from inpatient admissions between 1 October 2007 and 30 November 2010. Nosocomial GNB-positive cultures were defined as clinical cultures positive for Acinetobacter, Pseudomonas, or Enterobacteriaceae between 48 h after admission and discharge. Positive cultures were further classified by site and level of resistance. We conducted analyses using both a conventional approach and an approach aimed at reducing the impact of time-dependent bias. In both instances, we used multivariable generalized linear models to compare the inpatient costs and length of stay for patients with and without a nosocomial GNB culture. Of the 404,652 patients included in the conventional analysis, 12,356 had a nosocomial GNB-positive culture. The excess costs of nosocomial GNB-positive cultures wer...Continue Reading

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Citations

Jan 30, 2021·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Richard E NelsonJames Baggs
Jan 30, 2021·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Richard E NelsonMichael A Rubin

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