Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 23, Number 9—September 2017
Dispatch

Cost of Nosocomial Outbreak Caused by NDM-1–Containing Klebsiella pneumoniae in the Netherlands, October 2015–January 2016

Madelief Mollers, Suzanne P. Lutgens, Annelot F. Schoffelen, Peter M. Schneeberger, and Anita W.M. SuijkerbuijkComments to Author 
Author affiliations: European Centre for Disease Prevention and Control, Stockholm, Sweden (M. Mollers); National Institute for Public Health and the Environment, Bilthoven, the Netherlands (M. Mollers, A.F. Schoffelen, A.W.M. Suijkerbuijk); Jeroen Bosch Hospital, ’s-Hertogenbosch, the Netherlands (S.P. Lutgens, P.M. Schneeberger)

Main Article

Table

Total outbreak costs stratified by type of cost, Jeroen Bosch hospital, the Netherlands, Oct 2015–Jan 2016*

Type of cost Explanation Total cost, US $ Total cost, €
Diagnostics
Other laboratory personnel Estimated 2,517 h† 93,789 76,251
Microbiological tests Material costs to perform cultures in batches 60,070 48,837
Microbiologists Estimated 376 h† 46,017 37,412
Molecular diagnostics Material costs to perform PCRs in batches 24,523 19,937
Subtotal diagnostics

224,399
182,437
Ward-related costs
No. blocked beds 582 beds, occupancy rate 0.85 at $550/d or €447/d (5) 272,085 221,131
Personal protective equipment Expenditures for extra disposable aprons, gloves, and masks 55,121 44,814
Cleaning wards Purchase of 2 fogging devices and personnel time for extra cleaning 46,881 38,115
Subtotal ward-related costs

374,087
304,060
Other outbreak control costs
Infection prevention experts Estimated 2,336 h for internal advice and guidance† 105,356 85,655
Patients in isolation 280 patients, averaged at 5.2 d of hospitalization, at $31.40/d or €25.53/d (6) 45,718 37,172
Staff meetings 23 staff meetings with on average 21 participants × 0.75 h × $1,525/h† 26,306 21,390
Communication 320 h for internal and patient-related communication spent by several communication employees† 17,696 14,387
Costs for mailings 10,701 8,700
Subtotal outbreak control costs

205,777
167,304
Total costs 804,263 653,801

*Resource use related to this outbreak was provided by the hospital.
†Labor costs/h were determined by using the Dutch manual for economic evaluations (5).

Main Article

References
  1. Yong  D, Toleman  MA, Giske  CG, Cho  HS, Sundman  K, Lee  K, et al. Characterization of a new metallo-beta-lactamase gene, bla(NDM-1), and a novel erythromycin esterase gene carried on a unique genetic structure in Klebsiella pneumoniae sequence type 14 from India. Antimicrob Agents Chemother. 2009;53:504654. DOIPubMedGoogle Scholar
  2. Glasner  C, Albiger  B, Buist  G, Tambić Andrasević  A, Canton  R, Carmeli  Y, et al.; European Survey on Carbapenemase-Producing Enterobacteriaceae (EuSCAPE) Working Group. Carbapenemase-producing Enterobacteriaceae in Europe: a survey among national experts from 39 countries, February 2013. Euro Surveill. 2013;18:20525. DOIPubMedGoogle Scholar
  3. Giske  CG, Monnet  DL, Cars  O, Carmeli  Y; ReAct-Action on Antibiotic Resistance. Clinical and economic impact of common multidrug-resistant gram-negative bacilli. Antimicrob Agents Chemother. 2008;52:81321. DOIPubMedGoogle Scholar
  4. Levy  SB, Marshall  B. Antibacterial resistance worldwide: causes, challenges and responses. Nat Med. 2004;10(Suppl):S1229. DOIPubMedGoogle Scholar
  5. Zorginstituut Nederland. Guidance for carrying out economic evaluations in healthcare [in Dutch]. Amsterdam: Zorginstituut Nederland; 2015.
  6. Wassenberg  MW, Kluytmans  JA, Box  AT, Bosboom  RW, Buiting  AG, van Elzakker  EP, et al. Rapid screening of methicillin-resistant Staphylococcus aureus using PCR and chromogenic agar: a prospective study to evaluate costs and effects. Clin Microbiol Infect. 2010;16:175461. DOIPubMedGoogle Scholar
  7. Ayraud-Thévenot  S, Huart  C, Mimoz  O, Taouqi  M, Laland  C, Bousseau  A, et al. Control of multi-drug-resistant Acinetobacter baumannii outbreaks in an intensive care unit: feasibility and economic impact of rapid unit closure. J Hosp Infect. 2012;82:2902. DOIPubMedGoogle Scholar
  8. Jiang  Y, Resch  S, Liu  X, Rogers  SO Jr, Askari  R, Klompas  M, et al. The cost of responding to an Acinetobacter outbreak in critically ill surgical patients. Surg Infect (Larchmt). 2016;17:5864. DOIPubMedGoogle Scholar
  9. Dik  JW, Dinkelacker  AG, Vemer  P, Lo-Ten-Foe  JR, Lokate  M, Sinha  B, et al. Cost-analysis of seven nosocomial outbreaks in an academic hospital. PLoS One. 2016;11:e0149226. DOIPubMedGoogle Scholar

Main Article

Page created: August 17, 2017
Page updated: August 17, 2017
Page reviewed: August 17, 2017
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external