TY - JOUR
T1 - Clostridioides difficile infection (CDI)
T2 - A pan-European multi-center cost and resource utilization study, results from the Combatting Bacterial Resistance in Europe CDI (COMBACTE-CDI)
AU - Wingen-Heimann, Sebastian M.
AU - Davies, Kerrie
AU - Viprey, Virginie F.
AU - Davis, Georgina
AU - Wilcox, Mark H.
AU - Vehreschild, Maria J.G.T.
AU - Lurienne, Lise
AU - Bandinelli, Pierre Alain
AU - Cornely, Oliver A.
AU - Vilken, Tuba
AU - Hopff, Sina M.
AU - Vehreschild, Jörg Janne
AU - Academic Partners, Partners
AU - Bonten, Marc
AU - Kuijper, Ed
AU - Rupnik, Maja
AU - Wingen-Heimann, Sebastian
AU - Tacconelli, Evelina
AU - Petrosillo, Nicola
AU - EFPIA Partners, Partners
AU - Pfizer Ltd, Ltd
AU - GlaxoSmithKline,
AU - bioMérieux,
AU - Pasteur, Sanofi
AU - Da Volterra, Volterra
AU - The Management Board of COMBACTE-CDI, Management Board of COMBACTE-CDI
AU - Cleuziat, Philippe
AU - Webber, Chris
N1 - Publisher Copyright:
© 2022 European Society of Clinical Microbiology and Infectious Diseases
PY - 2023/5
Y1 - 2023/5
N2 - Objectives: Clostridioides difficile infection (CDI) is one of the leading nosocomial infections worldwide, resulting in a significantly increasing burden on the healthcare systems. However, Pan-European data about cost and resource utilization of CDI treatment do not exist. Methods: A retrospective analysis within the Combatting Bacterial Resistance in Europe CDI project was conducted based on resource costs for inpatient treatment and productivity costs. Country-specific cost values were converted to EURO referred to 1 January, 2019 values. Differences in price levels for healthcare services among the participating countries were adjusted by using an international approach of the Organisation for Economic Co-operation and Development. As the study focused on patients with recurrent CDI, the observed study population was categorized into (a) patients with CDI but without CDI recurrence (case group), (b) patients with CDI recurrence (recurrence group), and (c) patients without CDI (control group). Results: Overall, 430 hospitalized patients from 12 European countries were included into the analysis between July 2018 and November 2018. Distribution of mean hospital length of stay and mean overall costs per patient between the case group, recurrence group, and control group were as follows: 22 days (95% CI 17–27 days) vs. 55 days (95% CI 17–94 days) vs. 26 days (95% CI 22–31 days; p 0.008) and € 15 242 (95% CI 10 593–19 891) vs. € 52 024 (95% CI 715–103 334) vs. € 21 759 (95% CI 16 484–27 035; p 0.010), respectively. The CDI recurrence rate during the observational period was 18%. Change escalation in CDI medication (OR 3.735) and treatment in an intensive care unit (OR 5.454) were found to be the most important variables associated with increased overall costs of patients with CDI. Conclusions: Treatment of patients with recurrent CDI results in a significant burden. Prevention of CDI recurrences should be in focus of daily patient care to identify the most cost-effective treatment strategy.
AB - Objectives: Clostridioides difficile infection (CDI) is one of the leading nosocomial infections worldwide, resulting in a significantly increasing burden on the healthcare systems. However, Pan-European data about cost and resource utilization of CDI treatment do not exist. Methods: A retrospective analysis within the Combatting Bacterial Resistance in Europe CDI project was conducted based on resource costs for inpatient treatment and productivity costs. Country-specific cost values were converted to EURO referred to 1 January, 2019 values. Differences in price levels for healthcare services among the participating countries were adjusted by using an international approach of the Organisation for Economic Co-operation and Development. As the study focused on patients with recurrent CDI, the observed study population was categorized into (a) patients with CDI but without CDI recurrence (case group), (b) patients with CDI recurrence (recurrence group), and (c) patients without CDI (control group). Results: Overall, 430 hospitalized patients from 12 European countries were included into the analysis between July 2018 and November 2018. Distribution of mean hospital length of stay and mean overall costs per patient between the case group, recurrence group, and control group were as follows: 22 days (95% CI 17–27 days) vs. 55 days (95% CI 17–94 days) vs. 26 days (95% CI 22–31 days; p 0.008) and € 15 242 (95% CI 10 593–19 891) vs. € 52 024 (95% CI 715–103 334) vs. € 21 759 (95% CI 16 484–27 035; p 0.010), respectively. The CDI recurrence rate during the observational period was 18%. Change escalation in CDI medication (OR 3.735) and treatment in an intensive care unit (OR 5.454) were found to be the most important variables associated with increased overall costs of patients with CDI. Conclusions: Treatment of patients with recurrent CDI results in a significant burden. Prevention of CDI recurrences should be in focus of daily patient care to identify the most cost-effective treatment strategy.
KW - Burden of Clostridioides difficile infection (CDI)
KW - CDI recurrence
KW - Guideline-based therapy
KW - Productivity costs
KW - Prolonged hospitalization
KW - Resource costs for inpatient treatment
UR - http://www.scopus.com/inward/record.url?scp=85146841271&partnerID=8YFLogxK
U2 - 10.1016/j.cmi.2022.12.019
DO - 10.1016/j.cmi.2022.12.019
M3 - Article
C2 - 36586512
AN - SCOPUS:85146841271
SN - 1198-743X
VL - 29
SP - 651.e1-651.e8
JO - Clinical Microbiology and Infection
JF - Clinical Microbiology and Infection
IS - 5
ER -