The incremental cost of infections associated with multidrug‐resistant organisms in the inpatient hospital setting—A national estimate

OBJECTIVE: To estimate the cost of infections associated with multidrug-resistant organisms (MDROs) during inpatient hospitalization in the United States. DATA SOURCES/STUDY SETTING: 2014 National Inpatient Sample. STUDY DESIGN: Multivariable regression models assessed the incremental effect of MDROs on the cost of hospitalization and hospital length of stay among patients with bacterial infections. DATA COLLECTION/EXTRACTION METHODS: We retrospectively identified 6 385 258 inpatient stays for patients with bacterial infection. PRINCIPAL FINDINGS: The national incidence rate of inpatient stays with bacterial infection is 20.1 percent. At least 10.8 percent of such stays-and as many as 16.9 percent if we account for undercoded infections-show evidence of one or more MDROs. MRSA, C. difficile, infection with another MDRO, and the presence of more than one MDRO are associated with $1718 (95% CI, $1609-$1826), $4617 (95% CI, $4407-$4827), $2302 (95% CI, $2044-$2560), and $3570 (95% CI, $3019-$4122) in additional costs per stay, respectively. The national cost of infections associated with MDROs is at least $2.39 billion (95% CI, $2.25-$2.52 billion) and as high as $3.38 billion (95% CI, $3.13-$3.62 billion) if we account for undercoded infections. CONCLUSIONS: Infections associated with MDROs result in a substantial cost burden to the US health care system.