OBJECTIVE To analyze the direct economic burden associated with carbapenem-resistant gram-negative bacteria (CRGNB) infections during hospitalization, and to provide reference for relevant policy formulation.

METHODS Basic information including ICU admission, International Classification of Diseases (ICD) codes and CRGNB infection of intensive care unit (ICU) inpatients from Sanya Central Hospital (the Third People′s Hospital of Hainan Province) in the southern Hainan region from 2019 to 2023 was collected for risk factor analysis. Propensity matching was performed between the CRGNB infection and non-infection subgroups, and the direct economic differences between the two groups were analyzed.

RESULTS A total of 164 373 cases were included. Multifactor logistic regression analysis revealed that ICD codes F00-F99, G00-G99, I00-I99, J00-J99, L00-L99, N00-N99, P00-P96 and S00-T98, ICU admission, hospital-acquired infection, readmission within 90 days and hospitalization exceeding 7 days were risk factors for CRGNB infection, especially, codes J00-J99 (respiratory system diseases) were 7.68 to 17.47 folds higer than codes C00-D48 (tumors). In the direct economic analysis of CRGNB infection, different matching results yielded consistent findings. In the 1∶1 matching results, a comparison of total hospitalization costs(yuan) between different groups showed that the infection group had higher total hospitalization costs than the non-infection group. The costs were as follows: CRGNB group (88 421.40 vs. 32 475.56), subgroup with two or more CRGNB types (130 984.02 vs. 47 367.27), group with CRGNB and other multidrug-resistant bacteria (103 056.35 vs. 37 724.78), CRAB group (98 486.01 vs. 36 487.98), and CRE group (26 031.38 vs. 17 621.82).

CONCLUSIONS The direct economic burden of CRGNB infection is greater than that of the non-infection group. Among them, the direct economic burden of carbapenem-resistant gram-negative bacteria infection, carbapenem-resistant gram-negative bacteria co-infected with other multidrug-resistant bacteria and CRAB infection are the highest.