As water infrastructure ages, cost of treating infections rise

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It is getting more expensive to treat America's infections. Antibiotic resistance is one reason, but potentially contaminated drinking water is becoming another factor.

So say researchers at Tufts University, who sifted through 100 million Medicare claims for payment submitted between 1991 and 2006. They found that $9 billion of payments were tied to the treatment of infections known as “common plumbing pathogens”--such as Legionnaire's disease--that lurk in water distribution systems. Their research was recently published in the Journal of Public Health Policy.

That's an average of $600 million per year.  But the study's authors believe that the annual cost in recent years is closer to $2 billion, exacerbated by antibiotic resistance. That was present in between 1 and 2 percent of the cases and raised their costs between 10 percent and 40 percent.

“Premise plumbing pathogens can be found in drinking water, showers, hot tubs, medical instruments, kitchens, swimming pools--almost any premise where people use public water. The observed upward trend in associated infections is likely to continue, and aging water distribution systems might soon be an additional reservoir of costly multi-drug resistance,” said lead study author Elena Naumova, professor at Tufts University and director of its Initiative for the Forecasting and Modeling of Infectious Disease, in a statement.  

“The Flint Water Crisis revealed many unsolved social, environmental, and public health problems for U.S. drinking water," Naumova said. "Unfortunately, water testing for pathogens is not done routinely; furthermore, most water tests are not accessible, are too complicated, or are too costly. Well-controlled, experimental studies of the influence of microbial ecology, disinfectant type, pipe materials, and water age, on opportunistic pathogen occurrence and persistence are needed in order to establish their relationships to drug resistance.”

Meanwhile, hospitals are under greater pressure to cure infections, due to the shift toward value-based payments. That's even as the rates of some drug-resistant infections have doubled in recent years.