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.