Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2021 Jan 6;10(1):5.
doi: 10.1186/s13756-020-00872-w.

Economic burden of antibiotic resistance in China: a national level estimate for inpatients

Xuemei Zhen  1   2 , Cecilia Stålsby Lundborg  3 , Xueshan Sun  1 , Nina Zhu  4 , Shuyan Gu  1   5 , Hengjin Dong  6   7
Affiliations
Multicenter Study

Economic burden of antibiotic resistance in China: a national level estimate for inpatients

Xuemei Zhen et al. Antimicrob Resist Infect Control. .

Erratum in

Abstract

Background: Antibiotic resistance (AR) threats public health in China. National-level estimation of economic burden of AR is lacking. We aimed to quantify the economic costs of AR in inpatients in China.

Methods: We performed a multicentre and retrospective cohort study including 15,990 patient episodes at four tertiary hospitals in China from 2013 to 2015 to assess the impact of AR on hospital mortality, length of stay, and costs. We estimated the societal economic burden of AR using findings from the cohort study and secondary data from national surveillance hubs and statistical reports.

Results: Patients with multi-drug resistant (MDR) infection or colonisation caused by Staphylococcus aureus, Enterococcus faecalis, Enterococcus faecium, Escherichia coli, Klebsiella pneumonia, Pseudomonas aeruginosa, and Acinetobacter baumannii experienced higher individual patient cost ($3391, 95% uncertainty interval (UI) $3188-3594), longer hospital stay (5.48 days, 95% UI 5.10-5.87 days), and higher in-hospital mortality rates (1.50%, 95% UI 1.29-1.70%). In China, 27.45% of bacterial infection or colonisation that occurred in inpatients were resistant, of which 15.77% were MDR. A societal economic burden attributed to AR was estimated to be $77 billion in 2017, which is equivalent to 0.37% of China's yearly gross domestic product, with $57 billion associated with MDR.

Conclusions: This is the first study to estimate national-level economic burden of AR in China. AR places a significant burden on patient health and healthcare systems. Estimation of economic costs of resistant infection or colonisation is the essential step towards building an economic case for global and national actions to combat AMR.

Keywords: Antibiotic resistance; China; Economic burden; Inpatient; Multi-drug resistance.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart to estimate national-level economic burden of antibiotic resistance in inpatients in China. YLLs years of life lost, YLDs years lived with disability, DALYs disability-adjusted life years, GDP gross domestic product, SDR single drug resistance, MDR multiple drug resistance, AR antibiotic resistance, LOS length of stay
Fig. 2
Fig. 2
The estimated number of inpatients with antibiotic resistance in China. SDR single-drug resistance, MDR multiple-drug resistance
See this image and copyright information in PMC

References

    1. World Health Organization. Antibiotic resistance. 2018. https://www.who.int/news-room/fact-sheets/detail/antibiotic-resistance. Accessed 11 Apr 2020.
    1. Heddini A, Cars O, Qiang S, Tomson G. Antibiotic resistance in China—a major future challenge. Lancet. 2009;373:30. doi: 10.1016/S0140-6736(08)61956-X. - DOI - PubMed
    1. Qiao M, Ying GG, Singer AC, Zhu YG. Review of antibiotic resistance in China and its environment. Environ Int. 2018;110:160–172. doi: 10.1016/j.envint.2017.10.016. - DOI - PubMed
    1. Wang J, Wang P, Wang X, Zheng Y, Xiao Y. Use and prescription of antibiotics in primary health care settings in China. JAMA Intern Med. 2014;174:1914–1920. doi: 10.1001/jamainternmed.2014.5214. - DOI - PubMed
    1. Van Boeckel TP, Gandra S, Ashok A, Caudron Q, Grenfell BT, Levin SA, et al. Global antibiotic consumption 2000 to 2010: an analysis of national pharmaceutical sales data. Lancet Infect Dis. 2014;14:742–750. doi: 10.1016/S1473-3099(14)70780-7. - DOI - PubMed

Publication types

MeSH terms