ArticleAntibiotics (Basel, Switzerland)2025
Impact of Antimicrobial-Resistant Bacterial Pneumonia on In-Hospital Mortality and Length of Hospital Stay: A Retrospective Cohort Study in Spain.
Article in Antibiotics (Basel, Switzerland), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesAntimicrobial resistance is a major global health threat. This study aimed to assess the impact of antimicrobial-resistant bacterial pneumonia on in-hospital mortality and length of hospital stay in Spain using a large, nationally representative cohort.
methodsA retrospective cohort study that used data from Spain's Registry of Specialized Health Care Activity (RAE-CMBD) between 2017 and 2022. Hospitalized adults with bacterial pneumonia were included. Hospitalization episodes with bacterial antimicrobial resistance, defined according to ICD-10-CM codes for antimicrobial resistance (Z16.1, Z16.2), were analyzed versus hospitalization episodes without these codes. Multivariate logistic regression models, adjusted for potential confounders (e.g., age, comorbidity, intensive care unit admission) and sensitivity analyses (Poisson regression and propensity score matching test), were performed.
resultsOf the 116,901 eligible hospitalizations, 6017 (5.15%) involved antimicrobial-resistant bacteria. Patients with antimicrobial-resistant bacterial pneumonia were older (median 75 vs. 72 years), had greater comorbidity (Elixhauser-van Walraven index: 8 vs. 5), and were more frequently admitted to the intensive care unit (22% vs. 14%). Crude in-hospital mortality was higher in the antimicrobial resistance group (18.46% vs. 10.05%,
conclusionsAntimicrobial resistance is associated with longer hospital stays and an up to 50% higher risk of mortality. Despite the implementation of control policies in place over the past decade, policymakers must strengthen AMR surveillance and ensure adequate resource allocation. Clinicians, in turn, must reinforce antimicrobial stewardship and incorporate rapid diagnostic tools to minimize the impact of antimicrobial resistance on patient outcomes.
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