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The Burden of Bloodstream Infections caused by multiresistant Bacteria (MRSA, ESBL) in European Hospitals

Duration: November 2011 - April 2013 (18 months)

Coordinating team:
Prof. Stephan Harbarth (Geneva, Switzerland)
Dr. Jan Beyersmann (Freiburg, Germany)
Prof. Hajo Grundmann
Dr. Marlieke de Kraker (Groningen, Netherlands)
Prof. Nicholas Graves (Brisbane, Australia)
Study statistician:
Arthur Allignol (IMBI and FDM)


Infections caused by methicillin-resistant Staphylococcus aureus (MRSA) and extended-spectrum beta-lactamase (ESBL) producing Enterobacteriaceae may add to the overall burden of healthcare-associated infections. Only few studies have examined accurately both the health and the economic impact of MRSA and ESBL-positive infections in European hospitals. Accurate epidemiologic data on the burden of MRSA and ESBL-positive bloodstream infections are needed to allow informed policy and clinical decision making.

The main objectives of the study are:

  1. To determine the health impact and mortality associated with MRSA and ESBL bloodstream infections in a cohort of European tertiary care centres (retrospective cohort study) .

  2. To quantify the economic impact associated with MRSA and ESBL bloodstream infection in the participating hospitals by estimating the excess length of stay in acute care wards and calculating the excess costs due to MRSA and ESBL bacteraemia from the hospital perspective, after adjustment for confounders and time-varying exposures (retrospective cohort study).

The project has been closed with the following major paper:

AJ Stewardson, A Allignol , J Beyersmann, N Graves, M Schumacher, R Meyer, E Tacconelli, G De Angelis, C Farina, F Pezzoli, X Bertrand, H Gbaguidi-Haore, J Edgeworth, O Tosas, JA Martinez, MP Ayala-Blanco, A Pan, A Zoncada, CA Marwick, D Nathwani, H Seifert, N Hos, S Hagel, M Pletz, S Harbarth, the TIMBER Study Group, "The health and economic burden of bloodstream infections caused by antimicrobial-susceptible and non-susceptible Enterobacteriaceae and Staphylococcus aureus in European hospitals, 2010 and 2011: a multicentre retrospective cohort study", Eurosurveillance, Vol. 21, PP. 21-33, 2016