Clinical and economic impact of hospital acquired infections by Pseudomonas auregenosa in a tertiary care teaching hospital in India

Aim: Pseudomonas aeruginosa (PA) is a leading cause of hospitalacquired infections (HAI), associated with increased morbidity, mortality, and cost of treatment. Determination of the clinical as well as the financial burden of such infections is of critical importance for all the stakeholders for rational and fair allocation of resources. Materials and Methods: This was a prospective observational study. Patients diagnosed with HAI with P. aeruginosa (HAPAI) were screened. The relevant data regarding the total duration of hospitalization (DOH) for the condition, direct and indirect cost of treatment, and antimicrobial utilization for the same was recorded. One-way analysis of variance and unpaired two-tailed t -test were used for comparison of data between the groups. P < 0.05 was considered statistically significant. Results: A total of 102 patients were identified to have HAPAI, with the mean duration of admission to isolation being 9.96 ± 4.28 days. Skin and soft-tissue infections were the most commonly found HAI. 42% of PA were multidrug-resistant. The DOH due to HAPAI was 27.86 ± 6.98 days, with the duration of antimicrobial therapy being 20.07 ± 7.29 days. The per-patient average economic burden due to HAPAI by PA was 1,09,158 ± 1,27,801 INR (1310 ± 1534 USD) with a median of 69,700 INR (836 USD). Possible ventilator-associated pneumonia and catheter-associated urinary tract infection were significantly associated with higher overall cost of treatment compared to other HAPAIs. Conclusion: The development of HAPAI imposes a significant clinical as well as a financial burden on the patient as well as the healthcare setting. The study highlights the necessity of taking effective preventive measures to decrease the incidence of the same.