Health economic burden of refractory and recurrent Clostridioides difficile infection in the inpatient setting of the German health care system - the IBIS Study.

IF 3.9 3区医学 Q1 INFECTIOUS DISEASES

Journal of Hospital Infection Pub Date : 2025-04-04 DOI:10.1016/j.jhin.2025.03.011

S M Wingen-Heimann, A Ullah, M R Cruz Aguilar, S K Gräfe, J Conrad, K Giesbrecht, K-P Hunfeld, C Lübbert, S Pützfeld, P A Reuken, M Schmitz-Rode, E Schalk, T Schmidt-Wilcke, S Schmiedel, P Solbach, M J G T Vehreschild

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引用次数: 0

Abstract

Background: Clostridioides difficile infections (CDI) remain a prevalent and costly healthcare challenge, particularly affecting elderly, comorbid patients. Evidence on the health economic burden of CDI in Germany, particularly in refractory and recurrent patients is limited.

Methods: The IBIS study was a non-interventional retrospective and prospective study conducted from 08/2017 to 09/2020 in 10 German hospitals to assess the health economic burden of inpatient CDI treatment. It categorized CDI episodes into initial, refractory and recurrent, following the current ESCMID guidelines. A micro-costing approach from the societal perspective was applied, considering personnel, material, and infrastructure costs for treatment on different types of hospital wards, targeted antibiotic CDI therapies, and productivity losses due to illness related disability.

Results: Mean total costs per patient were €13,607 (95% CI: €12,124-€15,171) for the initial, €19,953 (95% CI: €16,839-€23,377) refractory and €22,671 (95% CI: €16,088-€30,474; P<0.001) for the recurrence group. Treatment on a general ward was the most important cost driver. Mean hospital length of stay in the initial, refractory group and recurrence group was 30 (95% CI: 27-33,) vs. 41 (95% CI: 35-46) vs. 47 days (95% CI: 37-57; P<0.001), respectively. Patients with initial, refractory and recurrent CDI required 11 (95% CI: 10-11), 15 (95% CI: 13-16), and 24 days (95% CI: 22-27; P<0.001) of targeted antibiotic therapy for CDI.

Conclusion: The IBIS study contributes valuable insights to the health economic burden of refractory and recurrent CDI in the German inpatient setting and underlines the importance of effective first-line treatment to improve treatment outcomes and reduce overall costs related with CDI.

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来源期刊

Journal of Hospital Infection 医学-传染病学

CiteScore

12.70

自引率

5.80%

发文量

271

审稿时长

19 days

期刊介绍： The Journal of Hospital Infection is the editorially independent scientific publication of the Healthcare Infection Society. The aim of the Journal is to publish high quality research and information relating to infection prevention and control that is relevant to an international audience. The Journal welcomes submissions that relate to all aspects of infection prevention and control in healthcare settings. This includes submissions that: provide new insight into the epidemiology, surveillance, or prevention and control of healthcare-associated infections and antimicrobial resistance in healthcare settings; provide new insight into cleaning, disinfection and decontamination; provide new insight into the design of healthcare premises; describe novel aspects of outbreaks of infection; throw light on techniques for effective antimicrobial stewardship; describe novel techniques (laboratory-based or point of care) for the detection of infection or antimicrobial resistance in the healthcare setting, particularly if these can be used to facilitate infection prevention and control; improve understanding of the motivations of safe healthcare behaviour, or describe techniques for achieving behavioural and cultural change; improve understanding of the use of IT systems in infection surveillance and prevention and control.