Epidemiological and economic burden of Clostridium difficile in the United States: estimates from a modeling approach

BMC Infectious Diseases

Research Article

Chantelle Browne¹  Kamal Desai¹  T. Christopher Mast²  Vimalanand S. Prabhu²  Swati B. Gupta³  Erik R. Dubberke⁴ 

[1] Evidera Inc., London, UK;Merck & Co., Inc., Kenilworth, NJ, USA;Merck & Co., Inc., Kenilworth, NJ, USA;Merck & Co., Inc, 770 Sumneytown Pike, 19486, West Point, PA, USA;Washington University School of Medicine, St. Louis, MO, USA;

关键词: Cost;    Community;    Hospital;    Long-term care;    NAP1;   

DOI  :  10.1186/s12879-016-1610-3

 received in 2015-06-27, accepted in 2016-06-01,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundDespite a large increase in Clostridium difficile infection (CDI) severity, morbidity and mortality in the US since the early 2000s, CDI burden estimates have had limited generalizability and comparability due to widely varying clinical settings, populations, or study designs.MethodsA decision-analytic model incorporating key input parameters important in CDI epidemiology was developed to estimate the annual number of initial and recurrent CDI cases, attributable and all-cause deaths, economic burden in the general population, and specific number of high-risk patients in different healthcare settings and the community in the US. Economic burden was calculated adopting a societal perspective using a bottom-up approach that identified healthcare resources consumed in the management of CDI.ResultsAnnually, a total of 606,058 (439,237 initial and 166,821 recurrent) episodes of CDI were predicted in 2014: 34.3 % arose from community exposure. Over 44,500 CDI-attributable deaths in 2014 were estimated to occur. High-risk susceptible individuals representing 5 % of the total hospital population accounted for 23 % of hospitalized CDI patients. The economic cost of CDI was $5.4 billion ($4.7 billion (86.7 %) in healthcare settings; $725 million (13.3 %) in the community), mostly due to hospitalization.ConclusionsA modeling framework provides more comprehensive and detailed national-level estimates of CDI cases, recurrences, deaths and cost in different patient groups than currently available from separate individual studies. As new treatments for CDI are developed, this model can provide reliable estimates to better focus healthcare resources to those specific age-groups, risk-groups, and care settings in the US where they are most needed. (Trial Identifier ClinicaTrials.gov: NCT01241552)

【 授权许可】

CC BY   
© The Author(s). 2016