Device-associated healthcare-associated infections in an intensive care unit in Türkiye: trends and additional costs - a retrospective propensity matched cohort analysis
BMC Health Services Research, vol.26, no.1, 2026 (SCI-Expanded, Scopus)
- Publication Type: Article / Article
- Volume: 26 Issue: 1
- Publication Date: 2026
- Doi Number: 10.1186/s12913-026-14833-3
- Journal Name: BMC Health Services Research
- Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, ABI/INFORM, CINAHL, EMBASE, MEDLINE, Directory of Open Access Journals, Academic Search Ultimate (EBSCO), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest)
- Keywords: Cost analysis, Device-associated healthcare-associated infection, Healthcare-associated infection, Intensive care unit, Propensity score matching
- Istanbul University Affiliated: Yes
Abstract
Background: The additional costs of healthcare-associated infections (HAIs) impose a significant burden on healthcare systems, limiting resources for other critical health priorities. This study evaluated device-associated healthcare-associated infections (DA-HAIs) in an adult intensive care unit (ICU) and examined their associated costs. Materials and methods: A 1:1 case-control matching was performed using a propensity score matching (PSM) model to assess hospital-acquired infection costs. Data from 700 hospitalizations between 2016 and 2018 at the Anesthesiology and Reanimation ICU of Istanbul University Istanbul Medical Faculty were analyzed. Confounding factors were identified using multivariable linear regression, and PSM was applied to account for case-control differences. DA-HAI incidence and invasive device utilization over the past 15 years since the start of routine surveillance were also examined. Results: HAIs occurred in 99 (14.1%) hospitalizations, 18 involving multiple infections. Using PSM, 81 HAI cases were optimally matched. The additional costs of ICU stays due to DA-HAIs were $6,781 for ventilator-associated pneumonia (VAP) (n = 26, p ≤ 0.001), $2,037 for central line-associated bloodstream infections (CLABSI) (n = 25, p > 0.05), $5,320 for catheter-associated urinary tract infections (CAUTI) (n = 12, p = 0.001), and $4,213 for all HAIs (n = 81, p ≤ 0.001). Conclusion: DA-HAIs substantially increased ICU stays and generated substantial additional costs. DA-HAI incidence densities were at the highest levels according to NHSN criteria.