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In-person registration included the full virtual experience, and virtual-only attendees will be able to tune into live in-person sessions and/or watch captured in-person sessions on-demand in addition to having a variety of virtual-only sessions to attend.

Outcomes and Costs Associated with Central Venous Catheter-Related S. Aureus Bloodstream Infections in Adult Hemodialysis Patients with S. Aureus Nares Colonization

Speaker(s)

Lodise T1, Berne L2, Young C3, Callahan M3, Patel N4
1Albany College of Pharmacy and Health Sciences, Watervliet, NY, USA, 2BAL Pharma Consulting, Princeton, NJ, USA, 3Botanix Pharmaceuticals Limited, North Perth, Western Australia, Australia, 4University of California San Diego, San Diego, CA, USA

Presentation Documents

OBJECTIVES: Despite advances in infection control and catheter care, central venous catheter (CVC)-related S. aureus bloodstream infections (SA-BSI) rates in adult patients on hemodialysis using a CVC (CVC-HD) remains high, especially among CVC-HD patients with SA nares colonization. This study sought to estimate the yearly costs associated with CVC-related SA-BSIs in adult CVC-HD patients with SA nares colonization.

METHODS: A probabilistic model from the US Healthcare Perspective over a 1-year time horizon was developed. The study population consisted of ~90,000 patients who start in-center CVC-HD per year (United States Renal Data System (USRDS)). Markov modeling (four 12-week cycles) was used to simulate transitions between different health-related dynamic states of CVC-HD patients (CVC, CVC with prior SA-BSI, death, and CVC removal) and estimate the frequency of CVC-related SA-BSI-related outcomes over 1-year period. The time on CVC among incident CVC-HD patients over 1 year (USRDS), presence of SA nasal colonization among CVC-HD patients (40%), frequency of CVC-related SA-BSIs among SA colonized CVC-HD patients (2.5 CVC-related SA-BSIs per 100 person-months), 12-week SA-BSI-related costs ($47,285), SA-BSI relapse rate among SA-BSI survivors (15%), and SA-BSI relapse costs ($42,352) were identified through a comprehensive literature search. Analyses were performed in TreeAge Pro Healthcare.

RESULTS: Data indicate 36,000 of the 90,000 annual incident CVC-HD patients are colonized with SA in their nares. Among SA nares colonized CVC-HD patients, the model estimates that there are ~6,300 CVC-related SA-BSIs, 1,170 SA-BSI relapses, and 960 SA-BSI-related deaths annually. Attributable costs associated with SA-BSI in CVC-HD patients with SA nares colonization are projected to be $350 million annually.

CONCLUSION: Annual morbidity, mortality, and healthcare costs associated with CVC-related SA-BSIs in SA nares colonized CVC-HD patients are substantial. Interventions designed at preventing CVC-related SA-BSIs in SA nares colonized CVC-HD patients are sorely needed to minimize the deleterious outcomes associated with CVC-related SA-BSIs.

Code

EE394

Topic

Economic Evaluation

Disease

Infectious Disease (non-vaccine), Urinary/Kidney Disorders