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Exploring Hospital-Onset Bacteremia: The Costs and Implications of Non-Catheter-Associated Infections

In the realm of healthcare, understanding the sources and impacts of hospital-onset bacteremia and fungemia is critically important. Recent research has revealed that non-catheter-associated hospital-onset infections are a common contributor towards hospital-onset bacteremia and fungemia, frequently leading to extended hospital stays and increased costs. This revelation has come into the spotlight at a time when the Centers for Disease Control and Prevention (CDC) is preparing to encourage voluntary reporting of such cases. This initiative comes on the back of an independent review by Battelle, endorsing the use of hospital-onset bacteremia and fungemia (HOB) as a potential quality metric for the Centers for Medicare and Medicaid Services (CMS).

While the reporting of these events is set in place, what remains less studied is the attributable major sources of HOB events. In order to shed light on this, a team of infectious disease researchers conducted a retrospective observational study using data from 43 acute-care hospitals. They focused on understanding the rate of HOB arising from catheter-associated urinary tract infections (CAUTIs) and non-CAUTI hospital-onset urinary tract infections (HOUTIs). The outcomes investigated included secondary HOB, total hospital expenditure, length of stay, risk of readmission, and patient mortality.

The study, encompassing 549,433 admissions, recorded 434 CAUTIs and 3,177 non-CAUTI HOUTIs. It was found that non-CAUTI HOUTIs are more likely to result in secondary HOB compared to CAUTIs. Furthermore, when analyzing the total hospital costs and the length of hospital stay, both CAUTI and non-CAUTI HOUTI had significant impacts, adding thousands of dollars to care costs and extending stay by approximately three days. Interestingly, the research brought to the surface that non-CAUTI HOUTIs contribute to HOB bloodstream events, which carry higher mortality and readmission rates compared to urine infections alone.

The understanding and awareness of urine as a major source of HOB infections will hopefully aid in the implementation of more effective and targeted patient safety programs. These programs can place a greater emphasis on preventing both CAUTI and non-catheter UTIs, while also addressing the issue of HOB in the process. Prioritizing the prevention of these infections can be a crucial factor in improving patient outcomes, decreasing care costs, and raising the overall quality of patient healthcare.


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