Economic burden associated with multi-resistant gram-negative organisms compared with that for methicillin-resistant Staphylococcus aureus in a university teaching hospital

The aim of this study was to investigate the hospital costs of patients with multi-drug-resistant Gram-negative bacilli (MR-GNB) compared with those for patients with methicillin-resistant Staphylococcus aureus (MRSA), using the Austrian performance-related hospital financing system (LKF). The study was performed retrospectively at Vienna General Hospital, a 2160-bed university teaching hospital, from January to June 2002. There were 99 patients in the MR-GNB group (median age 58 years) and 74 patients in the MRSA group (median age 60 years). More patients in the MR-GNB group (59 patients, 60%) were treated in the intensive care unit compared with patients in the MRSA group (25 patients, 34%) (P<0.01). The median hospital stay (42 and 37 days, respectively) and mortality (18 and nine deaths, respectively) of the two groups were similar. The total hospital cost for patients in the MR-GNB group was higher [4 915 712 LKF credit points (median: 34 180) equivalent to £2605 327 (median: £18 115)] than that for patients in the MRSA group [2 088 904 LKF credit points (median: 12 650) equivalent to £1 093 906 (median: £6624)] (P<0.01). This study is limited by being retrospective and having charge-based costings. However, it suggests that the hospital costs of patients with MR-GNB are substantial and may be greater than those of patients with MRSA.