Health and economic impacts of antimicrobial resistance.
For comparison of the impacts of infections due to antimicrobial-resistant bacteria with those of infections due to antimicrobial-susceptible strains of the same bacteria, data were evaluated from 175 published and unpublished reports of investigations of nosocomial and community-acquired infections with selected bacteria. The evaluation of outcomes of hospital-acquired infections with resistant organisms was often confounded by risk factors also associated with poor outcomes. Nevertheless, for both nosocomial and community-acquired infections, the mortality, the likelihood of hospitalization, and the length of hospital stay were usually at least twice as great for patients infected with drug-resistant strains as for those infected with drug-susceptible strains of the same bacteria. Poor outcomes could be attributed both to the expected effects of ineffective antimicrobial therapy and to the unexpected occurrence of drug-resistant infections complicated by prior antimicrobial therapy for other medical problems. Although the adverse economic and health effects of drug-resistant bacterial infections can only be roughly quantified, it is concluded that antimicrobial resistance is an important health problem and an economic burden to society.
Holmberg
S D
SD
Division of Bacterial Diseases, Centers for Disease Control, Atlanta, Georgia 30333.
Solomon
S L
SL
Blake
P A
PA
D001424:Bacterial Infections / Q000188:drug therapy / Q000191:economics* / Q000453:epidemiology; D003365:Costs and Cost Analysis; D003428:Cross Infection / Q000188:drug therapy / Q000191:economics* / Q000453:epidemiology; D004196:Disease Outbreaks; D004352:Drug Resistance, Microbial; D004405:Dysentery, Bacillary / Q000188:drug therapy / Q000191:economics / Q000453:epidemiology; D006801:Humans; D012480:Salmonella Infections / Q000188:drug therapy / Q000191:economics / Q000453:epidemiology; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000191:economics / Q000453:epidemiology; D014481:United States