title: Characteristics and costs of carbapenemase-producing enterobacteria carriers (2012/2013).
abstract: OBJECTIVE
  We had for aim to determine the characteristics of carbapenemase-producing enterobacteria (CPE) carriers and to assess the economic impact of isolation measures leading to loss of activity (closed beds, prolonged hospital stays) and additional personnel hours.
  
  
  METHODS
  We conducted a retrospective study for 2years (2012/2013), in a French general hospital, focusing on CPE carriers with clinical case description. The costs were estimated by comparing the activity of concerned units (excluding the ICU) during periods with CPE carriers or contacts, during the same periods of the year (n-1), plus additional hours and rectal swabs.
  
  
  RESULTS
  Sixteen EPC carriers were identified: 10 men and 6 women, 65±10years of age. Seven patients acquired EPC in hospital during 2 outbreaks in 2012. Four patients presented with an infection (peritonitis, catheter infection, and 2 cases of obstructive pyelonephritis) with a favorable outcome. The median length of stay was 21days [4,150]. Six patients died, 1 death was indirectly due to CPE because of inappropriate empiric antibiotic therapy. A decrease in activity was observed compared to the previous year with an estimated 547,303€ loss. The 1779 additional hours cost 63,870€, and 716 screening samples cost 30,931€. The total additional cost was estimated at 642,104€ for the institution.
  
  
  CONCLUSIONS
  Specialized teams for CPE carriers and isolation of contact patients, required to avoid/control epidemics, have an important additional cost. An appreciation of their support is needed, as well as participation of rehabilitation units.
authors.affiliation: Unité d'hygiène et d'épidémiologie, centre hospitalier intercommunal Robert-Ballanger, 93603 Aulnay-sous-Bois, France.
authors.forename: A
authors.initials: A
authors.lastname: Daroukh
authors.affiliation: Analyse de gestion, centre hospitalier intercommunal Robert-Ballanger, 93603 Aulnay-sous-Bois, France.
authors.forename: C
authors.initials: C
authors.lastname: Delaunay
authors.affiliation: Direction des ressources humaines, centre hospitalier intercommunal Robert-Ballanger, 93603 Aulnay-sous-Bois, France.
authors.forename: S
authors.initials: S
authors.lastname: Bigot
authors.affiliation: Département d'informatique médicale, centre hospitalier intercommunal Robert-Ballanger, 93603 Aulnay-sous-Bois, France.
authors.forename: J M
authors.initials: JM
authors.lastname: Ceci
authors.affiliation: Analyse de gestion, centre hospitalier intercommunal Robert-Ballanger, 93603 Aulnay-sous-Bois, France.
authors.forename: N
authors.initials: N
authors.lastname: Siddhoun
authors.affiliation: Service de médecine interne et maladies infectieuses, centre hospitalier intercommunal Robert-Ballanger, 93603 Aulnay-sous-Bois, France.
authors.forename: I
authors.initials: I
authors.lastname: Bukreyeva
authors.affiliation: Unité d'hygiène et d'épidémiologie, centre hospitalier intercommunal Robert-Ballanger, 93603 Aulnay-sous-Bois, France.
authors.forename: J
authors.initials: J
authors.lastname: Raisin
authors.affiliation: Biologie médicale, centre hospitalier intercommunal Robert-Ballanger, 93603 Aulnay-sous-Bois, France.
authors.forename: H
authors.initials: H
authors.lastname: Porcheret
authors.affiliation: Biologie médicale, centre hospitalier intercommunal Robert-Ballanger, 93603 Aulnay-sous-Bois, France.
authors.forename: L
authors.initials: L
authors.lastname: Maisonneuve
authors.affiliation: Service de médecine interne et maladies infectieuses, centre hospitalier intercommunal Robert-Ballanger, 93603 Aulnay-sous-Bois, France. Electronic address: marie-anne.bouldouyre@ch-aulnay.fr.
authors.forename: M A
authors.initials: MA
authors.lastname: Bouldouyre
mesh_terms: D000368:Aged; D001426:Bacterial Proteins / Q000032:analysis*; D015780:Carbapenems / Q000494:pharmacology; D002353:Carrier State / Q000191:economics / Q000453:epidemiology; D003428:Cross Infection / Q000191:economics / Q000453:epidemiology / Q000382:microbiology; D004196:Disease Outbreaks / Q000191:economics; D004755:Enterobacteriaceae / Q000201:enzymology* / Q000235:genetics / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000191:economics / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D005602:France / Q000453:epidemiology; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006757:Hospital Units / Q000191:economics; D006769:Hospitals, General / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D017053:Infection Control / Q000191:economics; D007362:Intensive Care Units / Q000191:economics; D007710:Klebsiella Infections / Q000191:economics / Q000453:epidemiology / Q000382:microbiology; D007711:Klebsiella pneumoniae / Q000201:enzymology; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010356:Patient Isolation / Q000191:economics; D010564:Personnel, Hospital / Q000191:economics; D012189:Retrospective Studies; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000032:analysis*
chemical_list: D001426:Bacterial Proteins; D015780:Carbapenems; D001618:beta-Lactamases; C063912:carbapenemase
keywords: Carbapenemase; Carbapenemase cost; Carbapenemase isolation; Carbapénèmase; Coût carbapénèmase; Isolement carbapénèmase