[Excess mortality and prolongation of stay due to bloodstream infections  caused by multiresistant pathogens in Germany].
BACKGROUND
Multiresistant pathogens cause substantial excess mortality and prolongation of hospital stay. However, until now there are no reliable estimates for Germany.


METHODS
Based on data of three recent publications from Europe and current German data on bloodstream infections because of methicillin-resistant S. aureus (MRSA) and extended spectrum beta-lactamase (ESBL) producing E. coli we calculated the number of patients dying from bloodstream infections because of MRSA- instead of methicillin-susceptible S. aureus (MSSA) or ESBL-producing E. coli instead of non-ESBL E. coli.


RESULTS
About 421 patients died in 2010 because they suffered from MRSA bloodstream infection instead of MSSA bloodstream infection. Excess mortality for bloodstream infections because ESBL-producing E. coli instead of non-ESBL E. coli was about 256 cases. Considering that bloodstream infections with other multiresistant pathogens also lead to higher mortality, between 800 to 1000 deaths can be expected because of the resistant variant of the pathogens. In addition, bloodstream infections with multiresistant pathogens lead to more than 12000 additional days in hospital in Germany.


CONCLUSIONS
Although this article does not include the burden of other healthcare-associated infections due to multiresistant pathogens the data for bloodstream infections alone demonstrate substantial excess burden and costs.
Institut für Hygiene und Umweltmedizin, Charité - Universitätsmedizin Berlin. petra.gastmeier@charite.de
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P
Gastmeier
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Schwab
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E
Meyer
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Geffers
D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D016470:Bacteremia / Q000188:drug therapy* / Q000191:economics / Q000401:mortality*; D004927:Escherichia coli Infections / Q000188:drug therapy* / Q000191:economics / Q000401:mortality*; D005858:Germany; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data*; D055624:Methicillin-Resistant Staphylococcus aureus; D018805:Sepsis / Q000188:drug therapy* / Q000191:economics / Q000401:mortality*; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000191:economics / Q000401:mortality*; D015996:Survival Rate; D018440:beta-Lactam Resistance
D000900:Anti-Bacterial Agents