Bacterial distribution and disease burden analysis in hospital-acquired bloodstream infections according to Diagnosis-Related Groups (DRGs) data

Hospital-acquired bloodstream infections (HA-BSIs) create a heavy burden by prolonging hospitalization and increasing costs. Diagnosis-Related Groups (DRGs) framework helps mitigate this by identifying high-risk patients for targeted control. A retrospective study was conducted using data from the Fifth Affiliated Hospital of Sun Yat-sen University (2022–2023). The study assessed differences in average length of hospital stay (ALOS) and costs between bloodstream infection (BSI) and non-BSI groups through comprehensive comparisons (overall, major diagnostic category (MDC) and DRG-stratified). Furthermore, the study deeply explored the associations among bacterial distribution, influencing factors and economic burden in high-incidence DRG subgroups. Among 133,692 DRG discharge cases, 263 HA-BSI cases (0.20%) were identified. Infected groups showed significantly longer ALOS and higher costs than non-infected groups (p < 0.001), with HA-BSI subgroups also showing this trend (p < 0.001). These cases distributed across 19 MDCs (covering 79 DRGs), with MDCR (25.86%, highest concentration), MDCS (16.35%), and MDCA (5.44%, highest incidence) as key MDCs; DRG concentrations included SR11 (11.41%), RU10 (7.60%), and RR11 (20.41%). Pathogens were predominantly Gram-negative (56.98%), led by Escherichia coli(23.26%) and Klebsiella pneumoniae(12.40%). To mitigate the disproportionate clinical and economic burden of HA-BSIs on specific patient groups under DRGs, implementing risk-stratified prevention is crucial. Simultaneously, empirical therapy must be optimized to target the predominant Gram-negative pathogens.