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Volume 23, Number 9—September 2017

Cost of Nosocomial Outbreak Caused by NDM-1–Containing Klebsiella pneumoniae in the Netherlands, October 2015–January 2016

Madelief Mollers, Suzanne P. Lutgens, Annelot F. Schoffelen, Peter M. Schneeberger, and Anita W.M. SuijkerbuijkComments to Author 
Author affiliations: European Centre for Disease Prevention and Control, Stockholm, Sweden (M. Mollers); National Institute for Public Health and the Environment, Bilthoven, the Netherlands (M. Mollers, A.F. Schoffelen, A.W.M. Suijkerbuijk); Jeroen Bosch Hospital, ’s-Hertogenbosch, the Netherlands (S.P. Lutgens, P.M. Schneeberger)

Main Article


Total outbreak costs stratified by type of cost, Jeroen Bosch hospital, the Netherlands, Oct 2015–Jan 2016*

Type of cost Explanation Total cost, US $ Total cost, €
Other laboratory personnel Estimated 2,517 h† 93,789 76,251
Microbiological tests Material costs to perform cultures in batches 60,070 48,837
Microbiologists Estimated 376 h† 46,017 37,412
Molecular diagnostics Material costs to perform PCRs in batches 24,523 19,937
Subtotal diagnostics

Ward-related costs
No. blocked beds 582 beds, occupancy rate 0.85 at $550/d or €447/d (5) 272,085 221,131
Personal protective equipment Expenditures for extra disposable aprons, gloves, and masks 55,121 44,814
Cleaning wards Purchase of 2 fogging devices and personnel time for extra cleaning 46,881 38,115
Subtotal ward-related costs

Other outbreak control costs
Infection prevention experts Estimated 2,336 h for internal advice and guidance† 105,356 85,655
Patients in isolation 280 patients, averaged at 5.2 d of hospitalization, at $31.40/d or €25.53/d (6) 45,718 37,172
Staff meetings 23 staff meetings with on average 21 participants × 0.75 h × $1,525/h† 26,306 21,390
Communication 320 h for internal and patient-related communication spent by several communication employees† 17,696 14,387
Costs for mailings 10,701 8,700
Subtotal outbreak control costs

Total costs 804,263 653,801

*Resource use related to this outbreak was provided by the hospital.
†Labor costs/h were determined by using the Dutch manual for economic evaluations (5).

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