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Vancomycin‐resistant enterococcal infections: Cause for concern?
Author(s) -
Snydman David R.
Publication year - 2003
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.500091116
Subject(s) - medicine , vancomycin , enterococcus , liver transplantation , intensive care medicine , gram positive bacterial infections , gram negative bacterial infections , vancomycin resistant enterococci , microbiology and biotechnology , antibiotics , transplantation , staphylococcus aureus , biology , bacteria , genetics
Objectives: To determine the economic and clinical outcomes associated with infection with vancomycin‐resistant Enterococcus (VRE) and to compare these outcomes to those associated with infection with vancomycin‐sensitive Enterococcus (VSE). Methods: During a 3‐month, prospective, cohort study of 117 high‐risk, critically ill patients we collected complete clinical and demographic and ICU cost data from all patients during their ICU stays. Results: After adjusting for variables in a stepwise multiple regression model VRE infections were associated with a median attributable increased ICU cost per patient of $33,251 (38,088 euros) and an increased length of hospital stay (LOS) of 22 days, while VSE infections were associated with an increased cost of $21,914 (25,102 euros) and an increased LOS of 27 days. The effect of VRE and VSE infections were not significantly different. Over the entire cohort the attributable cost per ICU patient day associated with VRE infection was $304 (348 euros). Conclusions: The attributable cost of ICU care associated with VRE infection is $33,251 (38,088 euros) and per ICU patient day was $304 (348 euros). VRE and VSE infections do not differ in associated cost of ICU care, LOS, or mortality. Any VRE control strategy is cost‐effective if the overall cost per ICU patient‐day is less than $304 (348 euros).