Attributable cost and length of stay for patients with central venous catheter-associated bloodstream infection in Mexico City intensive care units: a prospective, matched analysis.

Higuera, Francisco; Rangel-Frausto, Manuel Sigfrido; Rosenthal, Victor Daniel; Soto, Jose Martinez; Castañon, Jorge; Franco, Guillermo; Tabal-Galan, Natividad; Ruiz, Javier; Duarte, Pablo; Graves, Nicholas

BACKGROUND No information is available about the financial impact of central venous catheter (CVC)-associated bloodstream infection (BSI) in Mexico. OBJECTIVE To calculate the costs associated with BSI in intensive care units (ICUs) in Mexico City. DESIGN An 18-month (June 2002 through November 2003), prospective, nested case-control study of patients with and patients without BSI. SETTING Adult ICUs in 3 hospitals in Mexico City. PATIENTS AND METHODS A total of 55 patients with BSI (case patients) and 55 patients without BSI (control patients) were compared with respect to hospital, type of ICU, year of hospital admission, length of ICU stay, sex, age, and mean severity of illness score. Information about the length of ICU stay was obtained prospectively during daily rounds. The daily cost of ICU stay was provided by the finance department of each hospital. The cost of antibiotics prescribed for BSI was provided by the hospitals' pharmacy departments. RESULTS For case patients, the mean extra length of stay was 6.1 days, the mean extra cost of antibiotics was US dollars 598, the mean extra hospital cost was US dollars 11,591, and the attributable extra mortality was 20%. CONCLUSIONS In this study, the duration of ICU stay for patients with central venous catheter-associated BSI was significantly longer than that for control patients, resulting in increased healthcare costs and a higher attributable mortality. These conclusions support the need to implement preventive measures for hospitalized patients with central venous catheters in Mexico.