# Economic Impact in the Treatment of Coagulase-Negative Staphylococci Blood Cultures Contamination in a Middle-Income Country

## TL;DR

This study shows that blood culture contamination in a middle-income country leads to high unnecessary antibiotic use and healthcare costs, suggesting the need for better prevention strategies.

## Contribution

The study provides a breakeven analysis to guide cost-effective strategies for reducing unnecessary antimicrobial use due to blood culture contamination.

## Key findings

- The contamination rate was 9.9% among 8,072 blood cultures analyzed.
- Unnecessary antimicrobial use cost USD 73,970 annually, with an additional USD 3.87 million in hospital costs from extended stays.
- Rapid identification techniques could help reduce contamination-related costs and improve patient outcomes.

## Abstract

This study aimed to assess the clinical and economic impacts of blood culture contamination in a hospital situated in a low-middle-income country and the breakeven to implement strategies to avoid unnecessary antimicrobials.

This economic cross-sectional study was conducted at a tertiary hospital, and 8,072 blood cultures were analyzed. Antibiotic duration and cost were calculated in United States dollars (USD). A simulation with a breakeven curve to determine the balance between antimicrobial costs and time-to-result of coagulase-negative staphylococci in one blood culture (suggestive of contamination) was used to define the breakeven point between the cost of the diagnostic tests or prevention strategies and the balance with antimicrobial expense.

Of the 8,072 blood culture samples collected, the contamination rate was 9.9%. Antimicrobial therapy was initiated in 69.6% of the 682 cases of contamination. The median duration of unnecessary antibiotic use was 7 days. The direct costs totaled USD 83,910 annually, comprising USD 73,970 for unnecessary antimicrobials and USD 9,940 for microbiological tests. The extended length of hospital stay potentially contributed to an additional USD 3.87 million in annual hospital costs.

This study underscores the urgent need for strategies to reduce blood culture contamination, and emphasizes the potential benefits of rapid identification techniques for optimizing patient care and healthcare resource utilization. Addressing this issue is of paramount importance for mitigating unnecessary antibiotic exposure, reducing healthcare costs, and improving patient outcomes.