Infections caused by Clostridioides difficile and methicillin-resistant Staphylococcus aureus (MRSA) resulted in 1,743 premature deaths in Canada in 2019 and cost Canadian hospitals more than $91 million, according to a new study published in the Canada Communicable Disease Report.
To estimate the mortality, hospital costs, and value of lost production associated with MRSA and C difficile, researchers with Health Canada and the University of Ottawa analyzed data from the Discharge Abstract Database, which contains administrative data on hospital discharges, diagnoses, and patient characteristics from facilities in all Canadian provinces except Quebec.
Using a two-step process, they estimated the number of cases for each diagnosis from 2010 through 2019 (dividing MRSA cases into bloodstream and non-bloodstream infections [BSIs]) and mortality associated with those cases. They then derived the average cost per case, hospital-related costs, and total economic costs.
There were a total of 16,070 and 9,889 cases of C difficile and MRSA infections, respectively, in Canada in 2019. Although C difficile fell during the study period, MRSA BSIs more than doubled. After adjusting for sex and number of comorbidities, the number of deaths attributable to C difficile, MRSA non-BSIs, and MRSA BSIs was 1,309, 257, and 177, respectively. Most cases occurred in older age-groups, with 70% of deaths occurring in patients aged 75 and older.
The annual hospital-related costs attributable to C difficile and MRSA infections in 2019 were over $125 million in Canadian dollars (US $91.5 million), while the value of lost production was estimated to be between $18.8 and $146.9 million (Canadian). Total economic costs were estimated to be between $143.8 and $272 million (Canadian).
"Given the assumptions employed and noting that only two types of antimicrobial-resistant infections were incorporated in the analysis, these results can be considered lower values of the economic burden of antimicrobial-resistant infections in Canada," the study authors wrote.