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Drug-resistant bacterial infections in patients can aggravate disease conditions and prolong treatment durations, resulting in increased use of medical resources, and hinder measures aimed at moderating already strained health care costs. This study quantitatively estimated the additional medical resources used for drug-resistant bacterial infections, focusing on cases with penicillinresistant Streptococcus pneumoniae (PRSP) infections judged by the Japan Nosocomial Infection Surveillance (JANIS). JANIS data and Diagnosis Procedure Combination/Per-Diem Payment System data were analyzed. The JANIS program collects data directly from voluntarily participating hospitals. The patients with PRSP infection were deˆned by the JANIS data. All subjects were categorized based on their diseases and surgical procedures as recorded in the data. Pairs of subjects with and without PRSP infections in each category were then matched according to a propensity score. To investigate the additional medical resources used due to PRSP infections, the diŠerences in mean length of stay (LOS) and hospitalization costs were calculated between the matched pairs. The results showed that among all subjects, patients with PRSP infections had a mean LOS duration that was 2.79 days longer than uninfected patients. For patients under 5 years of age, PRSP infections resulted in an increase of 2.08 days in LOS and an additional 110,634 yen in hospitalization costs. This study presents a quantitative estimate of additional medical resources used due to PRSP infections. These drug-resistant bacterial infections resulted in clear increases in LOS among all patients, as well as increases in LOS and hospitalization costs in patients under 5 years of age. These ˆndings have wide potential applications and can support technical assessments for infection control based on cost eŠectiveness. Comprehensive infection control measures that target drug-resistant bacterial infections are expected to be further developed. Key wordspenicillin-resistant Streptococcus pneumoniae, propensity score matching, cost of illness, hospitalization cost, length of stay

Increased Burden on Medical Resources of Penicillin-Resistant Streptococcus Pneumoniae Infections: Estimates Using JANIS Data