scholarly journals 1322. Complications and Hospital Resource Utilization among Patients with Bacterial Nosocomial Pneumonia in the US, 2012-2019

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S749-S749
Author(s):  
Marya Zilberberg ◽  
Brian Nathanson ◽  
Laura A Puzniak ◽  
Noah Zilberberg ◽  
Andrew F Shorr
Keyword(s):  
Resource Utilization ◽  
Nosocomial Pneumonia ◽  
Post Infection ◽  
Hospital Costs ◽  
Cleveland Clinic ◽  
Extubation Failure ◽  
Research Database ◽  
Hospital Resource ◽  
Research Support ◽  
The Us

Abstract Background Nosocomial pneumonia (NP) remains a costly complication of hospitalization. Consisting of hospital-acquired ventilated (vHABP) and non-ventilated (nvHABP), and ventilator-associated (VABP) bacterial pneumonia, these conditions themselves are fraught with further complications. We examined hospital resource utilization (HRU) and the rates of important complications in these three groups in a large US database. Methods We conducted a multicenter retrospective cohort study within Premier Research database, a source containing administrative, pharmacy, and microbiology data. The three types of NP were identified based on a slightly modified, previously published ICD-9/10-CM algorithm,1 and compared with respect to hospital costs, length of stay (LOS) and development of C. difficile infection (CDI), extubation failure (EF), and reintubation (RT). CDI was identified by its treatment with metronidazole, vancomycin, or fidaxomicin. Marginal effects were derived from multivariable regression analyses. Results Among 17,819 patients who met the enrollment criteria, 26.5% had nvHABP, 25.6% vHAPB, and 47.9% VABP. Patients with nvHABP were oldest (mean 66.7+/-15.1 years) and those with VABP were youngest (59.7+/-16.6 years). vHABP was associated with the highest chronic disease burden (mean Charlson score 4.1+/-2.8) and VABP with lowest (3.2+/-2.5). Patients with nvHABP had lowest severity of acute illness (ICU 58.0%, vasopressors 7.7%), and those with vHABP were most likely to require vasopressors (38.8%). The adjusted EF and RT in vHABP and VABP, and CDI rates, and adjusted post-infection onset hospital LOS across all groups were similar. The adjusted marginal post-infection onset ICU LOS and total hospital costs relative to nvHABP were 5.9 (95% CI 5.4, 6.3) days and &6,814 (95% CI &3,637, &9,991) in vHABP, and 6.5 (95% CI 6.0, 6.9) days and &16,782 (95% CI &13,446, &20,118) in VABP. Conclusion Both HABP and VABP remain associated with significant morbidity and HRU in the US. VABP was associated with the longest post-infection ICU LOS and highest hospital costs. Reference 1. Zilberberg et al. Chest 2019;155:1119-30 Disclosures Marya Zilberberg, MD, MPH, Cleveland Clinic (Consultant)J&J (Shareholder)Lungpacer (Consultant, Grant/Research Support)Merck (Grant/Research Support)scPharma (Consultant)Sedana (Consultant, Grant/Research Support)Spero (Grant/Research Support) Brian Nathanson, PhD, Lungpacer (Grant/Research Support)Merck (Grant/Research Support)Spero (Grant/Research Support) Laura A. Puzniak, PhD, Merck & Co., Inc. (Employee) Andrew F. Shorr, MD, MPH, MBA, Merck (Consultant)

scholarly journals 1314. Descriptive Epidemiology of 30-day Readmissions among Survivors of Hospitalization with Bacterial Nosocomial Pneumonia in the US, 2012-2019

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S745-S745
Author(s):  
Marya Zilberberg ◽  
Brian Nathanson ◽  
Laura A Puzniak ◽  
Noah Zilberberg ◽  
Andrew F Shorr
Keyword(s):  
Nosocomial Pneumonia ◽  
Bacterial Pneumonia ◽  
Cleveland Clinic ◽  
Chronically Ill ◽  
Research Database ◽  
Principal Diagnosis ◽  
Research Support ◽  
Readmission Rates ◽  
Excess Morbidity ◽  
Hospital Acquired

Abstract Background Nosocomial pneumonia (NP) remains associated with excess morbidity and mortality. The effect of NP on other measures of outcome and quality, such as re-admission at 30 days, remains unclear. Moreover, differing types of NP may have varying impacts on re-admissions. Methods We conducted a multicenter retrospective cohort study within the Premier Research database, a source containing administrative, pharmacy, and microbiology data. The rate of rehospitalization at 30 days following the index discharge served as our primary endpoint. We compared NP patients readmitted with pneumonia (RaP) as the principal diagnosis to those readmitted for other reasons (RaO). We also compared readmission rates as function of the type of NP: ventilator-associated bacterial pneumonia (VABP), ventilated hospital-acquired bacterial pneumonia (vHABP), and non-ventilated HABP (nvHABP). Results Among 17,819 patients with NP, 14,123 (79.3%) survived to discharge, of whom 2,151 (15.2%) required an acute readmission within 30 days of index discharge. Of these, 106 (4.9%) were RaP, and the remainder were RaO. At index hospitalization, RaP patients were older (mean age (SD) 67.4 (13.9] vs. 63.0 (15.2) years), more likely medical (44.3% vs. 36.7%), and less chronically ill (median [IQR] Charlson scores (3 [2-5] vs. 4 [2-5]) than persons with RaO. Bacteremia (10.4% vs. 17.5%), need for vasopressors (15.1% vs. 20.0%), dialysis (9.4% vs. 16.5%), and/or sepsis (9.4% vs. 16.5%) or septic shock 14.2% vs. 17.1%) occurred less frequently in the RaP group. With respect to NP type, nvHABP was most common in RaP (47.2%) and VABP in RaO (38.1%). Conclusion One in seven survivors of a hospitalization complicated by NP requires an acute rehospitalization within 30 days. However, few of these readmissions had a principal diagnosis of pneumonia, irrespective of NP type. This suggests that short-term readmission does not capture the quality of care initially delivered to patients for their NP. Of the 5% of NP subjects with RaP, the plurality initially suffered from nvHABP. Disclosures Marya Zilberberg, MD, MPH, Cleveland Clinic (Consultant)J&J (Shareholder)Lungpacer (Consultant, Grant/Research Support)Merck (Grant/Research Support)scPharma (Consultant)Sedana (Consultant, Grant/Research Support)Spero (Grant/Research Support) Brian Nathanson, PhD, Lungpacer (Grant/Research Support)Merck (Grant/Research Support)Spero (Grant/Research Support) Laura A. Puzniak, PhD, Merck & Co., Inc. (Employee) Andrew F. Shorr, MD, MPH, MBA, Merck (Consultant)

scholarly journals 1427. Healthcare Resource Utilization During Hospitalizations with UTI in the US, 2018

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S796-S796
Author(s):  
Marya Zilberberg ◽  
Brian Nathanson ◽  
Kate Sulham
Keyword(s):  
Urinary Tract ◽  
Healthcare System ◽  
Resource Utilization ◽  
Hospital Admissions ◽  
Cleveland Clinic ◽  
Hospital Charges ◽  
Research Support ◽  
Hospitalization Costs ◽  
The Us ◽  
Tract Infections

Abstract Background Urinary tract infection (UTI) as the reason for hospitalization costs the US healthcare system nearly &3 billion annually, and is on the rise. We set out to explore the full burden of UTI hospitalizations in the US, including admissions both for UTI and with UTI. Methods We conducted a cross-sectional multicenter study within the National Inpatient Sample (NIS) database, a 20% stratified sample of discharges from US hospitals, from 2018, to explore hospital resource utilization of patients discharged with a UTI diagnosis. We divided UTI into mutually exclusive categories of complicated (cUTI), uncomplicated (uUTI), and catheter-associated (CAUTI), in addition to healthcare-associated (HAUTI). We calculated unadjusted hospital charges, costs, average reimbursements, and length of stay (LOS) associated with these infections. Results Among 2,837,385 discharges with a UTI code, 77.9% were uUTI, 17.6% cUTI (80.2% HAUTI), and 4.4% CAUTI; UTI was principal diagnosis in only 17.0%. Median [interquartile range, IQR] LOS ranged from 4 [3-8] days in uUTI and cUTI to 5 [3-9] days in CAUTI. Overall median [IQR] hospital charges and costs were lowest in uUTI (&36,335 [&19,920-&70,745] and &8,898 [&5,408-&16,092], respectively) and highest in cUTI (&39,690 [&21,997-&75,739] and &9,713 [&5,923-&17,423], respectively), with the HAUTI subgroup being most costly (&44,650 [&24,642-&85,628] and &10,945 [&6,573-&19,634], respectively). “Septicemia or Severe Sepsis without MV >96 Hours with MCC” was the most common DRG in uUTI (13.2%) and cUTI (14.2%), with the corresponding median [IQR] reimbursements of &11,057 [&7,028-&17,757] and &12,226 [&7,889-&19,216], respectively. In contrast, CAUTI was most commonly (44.7%) reimbursed under “Kidney and Urinary Tract Infections without MCC” at &8,635 [&5,693-&13,718]. Conclusion The nearly 3 million hospital admissions with a UTI represent 8% of all annual admissions in the US. Though the majority are considered uncomplicated, all categories are nearly equally costly. Given that over 80% of all UTI-associated admissions are with UTI as a secondary diagnosis, annual estimates of primary UTI costs likely significantly underrepresent the true economic burden of UTI on the US healthcare system. Disclosures Marya Zilberberg, MD, MPH, Cleveland Clinic (Consultant)J&J (Shareholder)Lungpacer (Consultant, Grant/Research Support)Merck (Grant/Research Support)scPharma (Consultant)Sedana (Consultant, Grant/Research Support)Spero (Grant/Research Support) Brian Nathanson, PhD, Lungpacer (Grant/Research Support)Merck (Grant/Research Support)Spero (Grant/Research Support) Kate Sulham, MPH, Spero Therapeutics (Consultant)

scholarly journals 786. Facility Reported vs. CLSI MIC Breakpoint Comparison of Carbapenem Non-susceptible (Carb-NS) Pseudomonas aeruginosa (PSA) From 2016-2019: A Multicenter Evaluation

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S490-S490
Author(s):  
Vikas Gupta ◽  
Kalvin Yu ◽  
Jason M Pogue ◽  
Janet Weeks ◽  
Cornelius J Clancy
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Skin Wound ◽  
Clinical Implications ◽  
Research Database ◽  
Research Support ◽  
Becton Dickinson ◽  
Minimal Impact ◽  
Commercial Test ◽  
The Us ◽  
Inpatient Settings

Abstract Background CLSI lowered Pseudomonas aeruginosa (PSA) Carbapenem (Carb) interpretive breakpoint minimum inhibitory concentrations (MICs) in 2012. It often takes several years for commercial test manufacturers and microbiology labs to incorporate revised breakpoints. We compare facility-reported rates of Carb-NS PSA to the 2012 CLSI MIC breakpoints, using a large nationwide database for isolates tested in 2016-2020 at United States (US) facilities. Table. Imipenem (IPM)/meropenem (MEM)/doripenem (DOR) interpretation (evaluable isolates) results for PSA. Methods All adults with a positive non-contaminant PSA culture (first isolate per 30-day period from blood, respiratory, urine, skin/wound, intra-abdominal, or other) in ambulatory and inpatient settings from 298 US hospitals from Q1 2016-Q4 2020 were evaluated (BD Insights Research Database, Becton, Dickinson & Company). Facility-reported Carb-non susceptible (NS) was defined as lab information system feed designations of susceptible (S), intermediate (I) or resistant (R) to imipenem (IPM), meropenem (MEM) and/or doripenem (DOR) per commercial panels. Where available, MICs were interpreted using CLSI 2012 Carb breakpoints (µg/ml) of ≤2 (S), 4 (I), ≥8 (R) for IPM/MEM/DOR. For evaluable PSA isolates we compared susceptibility results as reported by the facility to those using CLSI MIC breakpoints. Results Overall, 86.9% (255,844/294,426) of non-duplicate PSA isolates with facility-reported IPM/MEM/DOR susceptibility interpretations also had interpretable MIC results. S rates were 84.9% and 83.3% as reported by facilities and determined by CLSI criteria, respectively (Table). Facilities under-reported Carb-NS by 9.8%, using CLSI criteria as the standard (10.4% and 7.7% of R and I isolates, respectively, were missed by facility reporting). Conclusion Systematic application of CLSI breakpoints in 2016-20 would have had minimal impact on PSA S rates in the US. However, facility reporting failed to identify ~10% of Carb-NS isolates. The clinical implications of this observation are unknown. Facilities should know their local epidemiology, decide if under-reporting might be an issue, and assess if there is any impact on their patients. Disclosures Vikas Gupta, PharmD, BCPS, Becton, Dickinson and Company (Employee, Shareholder) Kalvin Yu, MD, BD (Employee) Jason M Pogue, PharmD, BCPS, BCIDP, Merck (Consultant)QPex (Consultant)Shionogi (Consultant)Utility Therapeutics (Consultant)VenatoRX (Consultant) Janet Weeks, PhD, Becton, Dickinson and Company (Employee) Cornelius J. Clancy, MD, Merck (Grant/Research Support)

scholarly journals 1420. Descriptive Epidemiology of UTI Hospitalizations in the US, 2018

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S794-S794
Author(s):  
Marya Zilberberg ◽  
Brian Nathanson ◽  
Kate Sulham
Keyword(s):  
Antimicrobial Resistance ◽  
Hospital Admissions ◽  
Survey Methods ◽  
Cleveland Clinic ◽  
Care Facility ◽  
Research Support ◽  
Indwelling Catheter ◽  
Comorbidity Burden ◽  
The Us ◽  
Tract Infections

Abstract Background In parallel with an increase in antimicrobial resistance, urinary tract infections (UTI), one of the most common diagnoses among hospitalized patients in the US, have been on the rise. Though mostly emphasized as a hospital-acquired complication among patients with an indwelling catheter, quantification of the full contemporary burden of UTI-associated hospitalizations is limited. Methods We conducted a cross-sectional multicenter study within the National Inpatient Sample (NIS) database, a 20-percent stratified sample of discharges from US community hospitals, from 2018, to explore characteristics of patients discharged with a UTI diagnosis. We divided UTI into mutually exclusive categories of complicated (cUTI), uncomplicated (uUTI), and catheter-associated (CAUTI). We applied survey methods to develop national estimates. Results Among 2,837,385 discharges with a UTI code, 77.9% were uUTI, 17.6% cUTI, and 4.4% CAUTI. Compared to patients with uUTI (mean age 69.0 years), those with CAUTI and cUTI were older (70.1 and 69.7 years), but had same comorbidity burden (mean Charlson 4.3) as cUTI (4.3) and lower than CAUTI (4.6). Compared to other geographic regions, the Northeast had the lowest proportion of uUTI (74.6%) and highest of cUTI (20.8%) while the South had highest uUTI (80.2%) and lowest cUTI (15.7%). Over 60% of all UTI, regardless of type, were in large, and nearly ½ in urban teaching, institutions, and >80% came through the emergency department. Antimicrobial resistance codes were infrequent, but extended spectrum beta-lactamase organisms were more common in CAUTI (2.7%) and cUTI (2.1%) than in uUTI (1.6%). Among the 83.0% of discharges whose UTI was a secondary diagnosis, sepsis was the most common principal diagnosis, ranging from 17.7% in uUTI to 22.3% in cUTI. Although relatively low across the board, hospital mortality was lowest in cUTI (2.8%) and highest in uUTI (3.9%). Discharges to a chronic care facility were most common in CAUTI (46.7%) and least common in cUTI (33.3%). Conclusion There are nearly 3 million hospital admissions with a UTI, comprising fully 8% of all annual admissions in the US. Though most are considered uncomplicated, there are few differences in characteristics or outcomes across the categories. Disclosures Marya Zilberberg, MD, MPH, Cleveland Clinic (Consultant)J&J (Shareholder)Lungpacer (Consultant, Grant/Research Support)Merck (Grant/Research Support)scPharma (Consultant)Sedana (Consultant, Grant/Research Support)Spero (Grant/Research Support) Brian Nathanson, PhD, Lungpacer (Grant/Research Support)Merck (Grant/Research Support)Spero (Grant/Research Support) Kate Sulham, MPH, Spero Therapeutics (Consultant)

Drivers of Hospital Costs in the Self-Pay Facelift (Rhytidectomy) Patient: Analysis of Hospital Resource Utilization in 1890 Patients

2017 ◽  
Vol 42 (2) ◽  
pp. 603-609 ◽  
Author(s):  
Anmol Chattha ◽  
Alexandra Bucknor ◽  
David Chi ◽  
Klaas Ultee ◽  
Austin D. Chen ◽  
...  
Keyword(s):  
Resource Utilization ◽  
Hospital Costs ◽  
The Self ◽  
Hospital Resource

scholarly journals 642. Facility Reported vs. CLSI MIC Breakpoint Comparison of Carbapenem Non-susceptible (Carb-NS) Enterobacteriaceae (ENT) from 2016-2019: A Multicenter Evaluation

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S423-S423
Author(s):  
Vikas Gupta ◽  
Kalvin Yu ◽  
Jason M Pogue ◽  
Janet Weeks ◽  
Cornelius J Clancy
Keyword(s):  
Inhibitory Concentration ◽  
The United States ◽  
Skin Wound ◽  
Research Database ◽  
Research Support ◽  
Becton Dickinson ◽  
Minimal Impact ◽  
Systematic Application ◽  
The Us ◽  
Inpatient Settings

Abstract Background Carbapenem (Carb) minimum inhibitory concentration (MIC) breakpoints were lowered by CLSI in 2010 and recognized by FDA in 2012. Adoption of revised breakpoints is often slow, which may lead to under-reporting of Carb non-susceptibility (NS) by facilities. We compare facility-reported rates of Carb-NS ENT to the CLSI MIC breakpoints for a large nationwide collection of isolates in the United States (US) from 2016-2019. Methods All adults with a positive non-contaminant ENT culture (first isolate of a species per 30-day period from blood, respiratory, urine, skin/wound, intra-abdominal, or other) in ambulatory/inpatient settings from up to 300 US hospitals from 2016-2019 were evaluated (BD Insights Research Database). Facility-reported Carb-NS was defined as: susceptible (S), intermediate (I) or R to ertapenem (ETP), imipenem (IPM), meropenem (MEM) and/or doripenem (DOR) per commercial panels. Where available, MICs were interpreted using CLSI 2010 MIC breakpoints (µg/ml): ≤ 0.5 (S), 1 (I), ≥ 2 (R) for ETP and ≤1 (S), 2 (I), and ≥ 4 (R) for IPM/MEM/DOR. For evaluable ENT isolates we compared susceptibility results as reported by the facility to CLSI MIC breakpoints. Results Overall, 77.4% (937,926/1,211,845) and 90.6% (2,157,785/2,381,824) non-duplicate ENT isolates with facility-reported susceptibility results also had interpretable MIC results for ETP and IPM/MEM/DOR, respectively (Tables). ETP S rates were 99.3% and 99.1% as reported by facilities and using CLSI criteria, respectively. S rates of other Carbs were 98.9% and 98.4% by facility reporting and CLSI criteria, respectively. Systematic application of CLSI breakpoints under-reported EPT-I and –R isolates by 24.2% and 16.4%, respectively, and identification of IPM/MEM/DOR-I and –R isolates by 31.3% and 22.7%, respectively. Conclusion Systematic application of CLSI breakpoints in 2016-19 would have had minimal impact on ENT S rates in the US. However, facility reporting failed to identify 18.8% of ETP I or R and 26.5% of IPM/MEM/DOR I or R isolates. The clinical implications of this observation are unknown. Facilities should know their local epidemiology, decide if under-reporting might be an issue, and assess if there is any impact on their patients. Disclosures Vikas Gupta, PharmD, BCPS, Becton, Dickinson and Company (Employee, Shareholder) Kalvin Yu, MD, BD (Employee) Jason M Pogue, PharmD, BCPS, BCIDP, Merck (Consultant)QPex (Consultant)Shionogi (Consultant)Utility Therapeutics (Consultant)VenatoRX (Consultant) Janet Weeks, PhD, Becton, Dickinson and Company (Employee) Cornelius J. Clancy, MD, Merck (Grant/Research Support)

scholarly journals Efficacy of BioFire FilmArray Gastrointestinal Panel (FGP) to Reduce Hospital Costs Associated With Contact Isolation: A Pragmatic Randomized Controlled Trial

2021 ◽  
Author(s):  
Giulio DiDiodato ◽  
Ashley Allan ◽  
Nellie Bradbury ◽  
Julia Brown ◽  
Kelly Cruise ◽  
...  
Keyword(s):  
Resource Utilization ◽  
Primary Outcome ◽  
Controlled Trial ◽  
Hospital Costs ◽  
Hospitalized Patients ◽  
Molecular Testing ◽  
Hospital Resource ◽  
Contact Isolation ◽  
Balanced Allocation ◽  
The Impact

Abstract Background: Molecular syndromic panels can rapidly detect common pathogens responsible for acute gastroenteritis in hospitalized patients. Their impact on both patient and healthcare system outcomes is uncertain compared to conventional stool testing. This randomized trial evaluates the impact of molecular testing on in-hospital resource utilization compared to conventional stool testing.Methods: Hospitalized patients with acute diarrheal illness were randomized 1:1 to either conventional or molecular stool testing with the BioFire FilmArray gastrointestinal panel (FGP). The primary outcome was duration of contact isolation, and secondary outcomes included other in-hospital resource utilization such as diagnostic imaging and antimicrobial use. Results: A total of 156 patients were randomized. Randomization resulted in a balanced allocation of patients across all 3 age strata (<18, 18-69, ≥70 years old). The proportion of positive stools was 20.5% vs 29.5% in the control and FGP groups, respectively (p=0.196). The median duration of contact isolation was 51 hours (interquartile range (iqr) 66) and 69 hours (iqr 81) in the conventional and FGP groups, respectively (p=0.0513). There were no significant differences in other in-hospital resource utilization between groups. Conclusions: There were no differences in in-hospital resource utilization observed between FGP and conventional stool testing groups. Trials Registration: ClinicalTrials.gov NCT04189874

scholarly journals A multicenter analysis of the clinical microbiology and antimicrobial usage in hospitalized patients in the US with or without COVID-19

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Laura Puzniak ◽  
Lyn Finelli ◽  
Kalvin C. Yu ◽  
Karri A. Bauer ◽  
Pamela Moise ◽  
...  
Keyword(s):  
Bacterial Infections ◽  
Research Database ◽  
Antimicrobial Usage ◽  
Antimicrobial Utilization ◽  
The Us ◽  
Testing Data ◽  
Microbiological Testing ◽  
Multicenter Analysis ◽  
Heavy Burden ◽  
Minimal Information

Abstract Background Past respiratory viral epidemics suggest that bacterial infections impact clinical outcomes. There is minimal information on potential co-pathogens in patients with coronavirus disease-2019 (COVID-19) in the US. We analyzed pathogens, antimicrobial use, and healthcare utilization in hospitalized US patients with and without severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). Methods This multicenter retrospective study included patients with > 1 day of inpatient admission and discharge/death between March 1 and May 31, 2020 at 241 US acute care hospitals in the BD Insights Research Database. We assessed microbiological testing data, antimicrobial utilization in admitted patients with ≥24 h of antimicrobial therapy, and length of stay (LOS). Results A total of 141,621 patients were tested for SARS-CoV-2 (17,003 [12.0%] positive) and 449,339 patients were not tested. Most (> 90%) patients tested for SARS-CoV-2 had additional microbiologic testing performed compared with 41.9% of SARS-CoV-2-untested patients. Non-SARS-CoV-2 pathogen rates were 20.9% for SARS-CoV-2-positive patients compared with 21.3 and 27.9% for SARS-CoV-2-negative and −untested patients, respectively. Gram-negative bacteria were the most common pathogens (45.5, 44.1, and 43.5% for SARS-CoV-2-positive, −negative, and −untested patients). SARS-CoV-2-positive patients had higher rates of hospital-onset (versus admission-onset) non-SARS-CoV-2 pathogens compared with SARS-CoV-2-negative or −untested patients (42.4, 22.2, and 19.5%, respectively), more antimicrobial usage (68.0, 45.2, and 25.1% of patients), and longer hospital LOS (mean [standard deviation (SD)] of 8.6 [11.4], 5.1 [8.9], and 4.2 [8.0] days) and intensive care unit (ICU) LOS (mean [SD] of 7.8 [8.5], 3.6 [6.2], and 3.6 [5.9] days). For all groups, the presence of a non-SARS-CoV-2 pathogen was associated with increased hospital LOS (mean [SD] days for patients with versus without a non-SARS-CoV-2 pathogen: 13.7 [15.7] vs 7.3 [9.6] days for SARS-CoV-2-positive patients, 8.2 [11.5] vs 4.3 [7.9] days for SARS-CoV-2-negative patients, and 7.1 [11.0] vs 3.9 [7.4] days for SARS-CoV-2-untested patients). Conclusions Despite similar rates of non-SARS-CoV-2 pathogens in SARS-CoV-2-positive, −negative, and −untested patients, SARS-CoV-2 was associated with higher rates of hospital-onset infections, greater antimicrobial usage, and extended hospital and ICU LOS. This finding highlights the heavy burden of the COVID-19 pandemic on healthcare systems and suggests possible opportunities for diagnostic and antimicrobial stewardship.

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