The additional costs of catheter-related bloodstream infections
in intensive care units
Purpose: The additional costs of health care-associated infections vary depending on the reimbursement
systems of different countries. We estimated the additional costs of central venous catheter-related
bloodstream infections (CVC-CRBSI) in Japan, which has a universal health insurance system covering
all citizens.
Methods: We conducted a retrospective matched case-control study. Twenty-two patients with CVCCRBSI
were identified among 2,148 patients treated between October 2011 and May 2014 in the intensive
care unit of Tokyo Medical University Hospital (1,015 beds). Twenty-two matched controls were
selected on the basis of 5 criteria. The drug and medical material costs and technical fees incurred from
the date of catheter insertion until hospital discharge were examined using a fee-for-service system. The
additional costs of CVC-CRBSI were calculated as the difference between the costs of cases and controls.
The contribution of antimicrobial drugs and the causative microorganism to the additional drug costs
were also assessed.
Results: The additional costs of CVC-CRBSI were estimated at $57,090 per case. Antimicrobial agents
comprised only about 10% of the additional drug costs. The additional costs of Candida infection were
almost twice those of CVC-CRBSI caused by other microorganisms.
Conclusions: The additional costs of CVC-CRBSI in Japan were estimated at $57,090 per case.