OBJECTIVE To assess the influence of hospital-associated carbapenem-resistant Klebsiella pneumoniae (CRKP) infection on direct economic burden of the intensive care unit (ICU) patients so as to provide bases for optimization of infection control strategies.

METHODS A total of 242 patients who were detected with CRKP were chosen from 5426 patients who were hospitalized in ICUs of Fuyang People's Hospital from Jan. 2021 to Dec. 2024, the enrolled patients were recruited as the research subjects and were divided into the CRKP infection group with 48 cases and the non-CRKP infection group with 194 cases according to the status of hospital-associated infections. The direct economic burden due to the CRKP infection was analyzed by propensity score matching (PSM) method.

RESULTS The isolation rate of CRKP was 39.93% (242/606), the incidence of hospital-associated infections was 0.88% (48/5426), ventilator-associated pneumonia were dominant, accounting for 43.75%. Totally 44 pairs were matched in a 1∶1 ratio by PSM. After the matching, the median total hospitalization costs of the CRKP infection group was 226, 079.17 yuan per case, more than 121, 615.56 yuan per case in the non-CRKP infection group (P < 0.05). The burden of western medicine costs was the highest composition of the costs, which was increased by 39, 166.45 yuan per case, and the cost of antibiotics was increased by 5251.20 yuan per case (all P < 0.05). The length of hospital stay extended by 11.00 days per case due to hospital-associated infections (40.00 days vs. 29.00 days, P < 0.05).

CONCLUSIONS The direct economic burden of the ICU patients is remarkably increased due to the hospital-associated CRKP infection, which is mainly from the increase of western medicine costs and extension of hospital stay. It is crucial to optimize the use of antibiotics and reduce the invasive procedures (such as removing ventilators as early as possible) so as to reduce the direct economic burden.