Excess burden associated with Clostridioides difficile infection in haematological patients occurring during hospitalization with induction chemotherapy in the USA. Issue 4 (April 2020)

• Record Type: Journal Article
• Authors: Duhalde, L.; Lurienne, L.; Wingen-Heimann, S.M.; Guillou, L.; Buffet, R.; Bandinelli, P.-A.
• Is Part Of: Journal of hospital infection. Volume 104:Issue 4(2020)
• Page Start: 560
• Page End: 566
• Publication Date: 2020-04
• Subjects: Clostridioides difficile infection -- Haematological malignancies -- Leukaemia -- Lymphoma -- Costs -- Real-world evidence; Cross infection -- Periodicals; Cross infection -- Prevention -- Periodicals; Nosocomial infections -- Periodicals; Nosocomial infections -- Prevention -- Periodicals; Cross Infection -- Periodicals; Cross Infection -- prevention & control -- Periodicals; Infection Control -- Periodicals; Electronic journals; 614.44
• DOI: 10.1016/j.jhin.2019.12.017
• Languages: English
• ISSNs: 0195-6701

Abstract

Summary: Background: Patients with haematological diseases are at high risk of developing Clostridioides difficile infection (CDI). Aim: The study aim was to describe excess length of stay and costs associated with CDI during the hospital stay for induction chemotherapy in the United States (USA). Methods: A retrospective analysis was conducted utilizing data from US databases of Truven Health Analytics®. Comprehensive hospitalization data of patients with induction chemotherapy due to acute myeloid leukaemia (AML), acute lymphoblastic leukaemia, Hodgkin lymphoma and non-Hodgkin lymphoma (NHL) were analysed. Patients with CDI occurring during the hospital stay were compared to controls through a case–control comparison of the direct treatment costs and length of stay was performed with an exact matching algorithm. Findings: A total of 2611 patients were included between January 2014 and December 2017. NHL (43.5%) and AML (38.4%) were the predominant underlying diseases and 15% of patients received a stem cell transplantation. During the matching, 105 CDI cases (CDI+) were compared with 801 controls (CDI−). On average, hospitalization costs were increased by US$36, 113 in CDI+ compared to CDI− patients ( P =0.009) and patients with CDI spent on average 8.9 additional days in hospital ( P =0.003). Conclusions: The findings highlight a significant burden associated with CDI in haematological patients undergoing induction chemotherapy in the USA. There is an important need for prevention of CDI in this specific patient population.