Program Schedule

1041
Economic Burden Associated with Key Gram-negative Pathogens among Patients with Complicated Urinary Tract Infections across US Hospitals

Session: Poster Abstract Session: UTIs: Management and Issues in DrugóResistance
Friday, October 10, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Background: cUTI is a frequent cause of hospitalization and results in considerable morbidity and mortality.  While this is well appreciated, scant data are available on the economic burden posed by the various Gram-negative pathogens that cause cUTIs.  The objectives of this study were to compare hospital length of stay (LOS) and total hospital costs for patients with cUTI due to different Gram-negative bacteria. 

Methods: Retrospective observational study using Premier research database was conducted.  Inclusion criteria: (1) age ≥ 18 years, (2) patients with an admission to hospital for > 2 days between 7/2012-6/2013, (3) primary diagnosis of cUTI by ICD-9 codes (590.1, 590.80, 590.8, and 599.0), (4) ICD-9 code for E. coli (041.4), K. pneumoniae (041.3), or Pseudomonas (041.7), and (5) received intravenous antibiotic within 3 days of hospital admission.  Demographics, comorbid conditions, and outcomes were compared between pathogens of interests.   

Results: During the study period, 20688 hospitalized patients had a primary diagnosis of a cUTI across 487 hospitals and met the above criteria. Patient characteristics and outcomes are presented in table below.

Patient Characteristics

E. coli

N=3343

K.pneumoniae

N=15404

Pseudomonas

N=1510

Polymicrobial

N=431

Age, mean(Sd)

73.5(15.1)

68.4(19.8)

74.1(15.2)

72.0(15.6)

Female, N (%)

2455(73.4)

12339(80.1)

741(49.1)

307(71.2)

Caucasian

2500(74.8)

11091(72.0)

1143(75.7)

305(70.8)

Charlson Comorbidity Score, N (%)

 

0

837(25.0)

5638(36.6)

390(25.8)

101(23.4)

1

817(24.4)

3899(25.3)

322(21.3)

115(26.7)

2

640(19.1)

2412(15.7)

306(20.3)

82(19.0)

>=3

1049(31.4)

3455(22.4)

492(32.6)

133(30.9)

Patient Outcomes

E. coli

N=3343

K. pneumoniae

N=15404

Pseudomonas

N=1510

Polymicrobial

N=431

 LOS, median(IQR)

4.0(3.0)

3.0(2.0)

5.0(4.0)

5.0(4.0)

Total Hospital Cost, median(IQR)

$ 5751.7(4657.4)

$ 5320.4(4087.3)

$ 7002.4(5673.3)

$ 6974.4(6106.0)

Conclusion: Economic burden associated with complicated urinary tract infection is substantial, especially for patients infected with gram negative infections. In our study, cUTI due to Pseudomonas and > 1 Gram-negative pathogen pose greater economic challenges underscoring the need for new agents to treat these increasingly difficult infections.

Michelle Mocarski, MPH1, Qi Zhao, MD, MPH1, Minming Ding, MS1, Shailja Dixit, MD, MS, MPH1 and Thomas Lodise, PharmD2, (1)Forest Research Institute, Jersey City, NJ, (2)Albany College of Pharmacy and Health Sciences, Albany, NY

Disclosures:

M. Mocarski, Forest Research Institute: Employee, Salary

Q. Zhao, Forest Research Institute: Employee, Salary

M. Ding, Forest Research Institute: Employee, Salary

S. Dixit, Forest Research Institute: Employee, Salary

T. Lodise, Forest Research Institute: Consultant, Consulting fee

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