Incidence and costs of ventilator-associated pneumonia in the adult intensive care unit of a tertiary referral hospital in Mexico

被引:24
|
作者
Sosa-Hernandez, Oscar [1 ]
Matias-Tellez, Bernadine [1 ]
Estrada-Hernandez, Abril [1 ]
Alethia Cureno-Diaz, Monica [2 ]
Manuel Bello-Lopez, Juan [3 ]
机构
[1] Hosp Juarez Mexico, Unidad Vigilancia Epidemiol Hosp, Av Inst Politecn Nacl 5160, Ciudad De Mexico 07760, Mexico
[2] Hosp Juarez Mexico, Direcc Planeac Estrateg, Ciudad De Mexico, Mexico
[3] Hosp Juarez Mexico, Unidad Invest Microbiol & Toxicol, Ciudad De Mexico, Mexico
关键词
Hospital stay; Multidrug-resistant bacteria; Health care cost; Bacterial infection; COMAMONAS-TESTOSTERONI; RISK-FACTORS; INFECTIONS; EPIDEMIOLOGY; MANAGEMENT; OUTCOMES; BACTEREMIA; PREVENTION; GUIDELINES; PATIENT;
D O I
10.1016/j.ajic.2019.02.031
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background: Ventilator-associated pneumonia (VAP) is defined as pneumonia that occurs after 48 hours of endotracheal intubation and initiation of mechanical ventilation. The aim of this work was to use a microcosting method to calculate the costs generated in 2017 for the care of patients with VAP at the Hospital Juarez de Mexico. Methods: We performed a cross-sectional, retrospective, analytical, and observational study of the databases of the registry of health care-associated infections (HAIs) in 2017, in addition to a micro-costing study. Results: We studied 48 VAP cases in an adult intensive care unit (AICU). In this period, 1668 ventilator days were identified, with an incidence rate of 28.8 per 1000 days. All cases were caused by multidrug-resistant (MDR) bacteria and the costs of their care exceeded the average costs for the use of antimicrobials. By calculating the profit on return as an association measure, we found that VAP caused by MDR bacteria confers 9 times the risk of increasing the costs of care above the expected average. Conclusions: The cost for a case of VAP in the AICU is high and has an impact on the institutional budget. Control measures to prevent the spread of bacteria, particularly MDR bacteria, must be put into place in order to avoid increases in hospital stay costs and mortality. (C) 2019 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
引用
收藏
页码:E21 / E25
页数:5
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