Observational studyPloS one2025
Healthcare utilization associated with antimicrobial resistance at a tertiary hospital in Vietnam: A retrospective observational study from 2016 to 2021.
Observational study in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Multidrug-resistant organism carriage in Vietnamese district hospitals before and after an antimicrobial stewardship intervention.Antimicrobial resistance and infection control · 2026Article
- Genotype-Phenotype Links Between Aminoglycoside-Modifying Enzymes and Aminoglycoside MICs in Aminoglycoside-ResistantMicroorganisms · 2026Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDespite the increasing burden of antimicrobial resistance (AMR), specifically on priority ESKAPE pathogens, studies examining the economic impact of AMR in low- and lower-middle-income countries have been scarce and require further investigation to optimize the post-COVID resource allocation.
objectivesTo quantify the incremental hospital costs and length of stay (LOS) associated with antimicrobial-resistant versus -susceptible among priority ESKAPE pathogens from the healthcare sector perspective.
methodsWe conducted a retrospective observational study of patients hospitalized at the Hospital for Tropical Diseases from 2016-2021 with non-duplicate isolates of any ESKAPE pathogens from clinical specimens. The patients were then stratified into resistant- and susceptible- groups by the WHO classification. Multivariate generalized linear regression and negative binomial regression with linear spline at COVID-19 occurrence were employed to evaluate the incremental hospital costs and LOS due to AMR, respectively. These regressions were adjusted for sociodemographic and clinical characteristics. We applied difference-in-difference (DiD) to estimate the differential cost between resistant and susceptible groups regarding COVID-19 change.
resultsDuring the six-year period, 4,197 out of 6,670 patients (62.92%) were isolated with priority pathogens, with the highest prevalence of priority pathogens observed in 3GCREC and MRSA (accounting for 45.63% and 25.33%, respectively). After covariate adjustments, the incremental hospital costs per resistant patient were significantly higher across most pathogens except for patients tested with MRSA results (average CRAB $3,980; CRPA $1,000; 3GCREC $444; 3GCRKP $1,942; MRSA -$326), while incremental LOS ranged from 1.40 days for 3GCREC (95%CI: 0.69-2.10 ) to 12.54 days for CRPA (95%CI: 11.12-13.97). COVID-19 significantly enlarged the hospital cost gaps between patients with antibiotic-resistant and antibiotic-susceptible profiles, with A.baumannii (CRAB vs. CSAB) showing the highest DiD at $9,116 (95%CI: $6,019-$12,213).
conclusionThe incremental hospital costs of AMR were significant, with the highest one observed in CRAB patients, and the difference between resistant and susceptible cases widened during the COVID-19 pandemic.
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