title: The additional costs of catheter-related bloodstream infections in intensive care units.
abstract: OBJECTIVE
  The additional costs of health care-associated infections vary depending on the reimbursement systems of different countries. We estimated the additional costs of central venous catheter-related bloodstream infections (CVC-CRBSI) in Japan, which has a universal health insurance system covering all citizens.
  
  
  METHODS
  We conducted a retrospective matched case-control study. Twenty-two patients with CVC-CRBSI were identified among 2,148 patients treated between October 2011 and May 2014 in the intensive care unit of Tokyo Medical University Hospital (1,015 beds). Twenty-two matched controls were selected on the basis of 5 criteria. The drug and medical material costs and technical fees incurred from the date of catheter insertion until hospital discharge were examined using a fee-for-service system. The additional costs of CVC-CRBSI were calculated as the difference between the costs of cases and controls. The contribution of antimicrobial drugs and the causative microorganism to the additional drug costs were also assessed.
  
  
  RESULTS
  The additional costs of CVC-CRBSI were estimated at $57,090 per case. Antimicrobial agents comprised only about 10% of the additional drug costs. The additional costs of Candida infection were almost twice those of CVC-CRBSI caused by other microorganisms.
  
  
  CONCLUSIONS
  The additional costs of CVC-CRBSI in Japan were estimated at $57,090 per case.
authors.affiliation: Department of Infection Control and Prevention, Tokyo Medical University Hospital, Tokyo, Japan. Electronic address: task300@tokyo-med.ac.jp.
authors.forename: Itaru
authors.initials: I
authors.lastname: Nakamura
authors.affiliation: Department of Infection Control and Prevention, Tokyo Medical University Hospital, Tokyo, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Fukushima
authors.affiliation: Department of Infection Control and Prevention, Tokyo Medical University Hospital, Tokyo, Japan.
authors.forename: Tsukako
authors.initials: T
authors.lastname: Hayakawa
authors.affiliation: Department of Medical Professions, Tokyo Medical University Hospital, Tokyo, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Sekiya
authors.affiliation: Department of Microbiology, Tokyo Medical University, Tokyo, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Matsumoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D055499:Catheter-Related Infections / Q000191:economics*; D005260:Female; D017048:Health Care Costs; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018805:Sepsis / Q000191:economics*; D014041:Tokyo
keywords: CRBSI; Candida; Costs analysis; Nonantimicrobial