Health economic burden of refractory and recurrent Clostridioides difficile infection in the inpatient setting of the German healthcare 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 (CDIs) 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 August 2017 to September 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.

Findings

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: 10–1), 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 to CDI.

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德国卫生保健系统住院患者难治性和复发性艰难梭菌感染的健康经济负担- IBIS研究。

背景：艰难梭菌感染（CDI）仍然是一个普遍和昂贵的医疗保健挑战，特别是影响老年人，合并症患者。关于德国CDI的卫生经济负担的证据有限，特别是在难治性和复发性患者中。方法：IBIS研究是一项非介入性回顾性和前瞻性研究，于2017年8月至2020年9月在10家德国医院进行，以评估住院患者CDI治疗的健康经济负担。根据目前的ESCMID指南，它将CDI发作分为初始、难治性和复发性。采用了从社会角度出发的微观成本计算方法，考虑了在不同类型的医院病房进行治疗的人员、材料和基础设施成本、针对性抗生素CDI治疗以及因疾病导致的残疾造成的生产力损失。结果：首发患者的平均总成本为13,607欧元（95% CI：€12,124-€15,171），难治性患者为19,953欧元（95% CI：€16,839-€23,377），22,671欧元(95% CI：€16,088-€30,474；结论：IBIS研究为德国住院患者难治性和复发性CDI的健康经济负担提供了有价值的见解，并强调了有效的一线治疗对于改善治疗结果和降低与CDI相关的总体成本的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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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.