The investment case for preventing NICU-associated infections

Edward F Donovan, Karen Sparling, Michael R Lake, Vivek Narendran, Kurt Schibler, Beth Haberman, Barbara Rose, Jareen Meinzen-Derr, Ohio Perinatal Quality Collaborative, Edward F Donovan, Karen Sparling, Michael R Lake, Vivek Narendran, Kurt Schibler, Beth Haberman, Barbara Rose, Jareen Meinzen-Derr, Ohio Perinatal Quality Collaborative

Abstract

Background: Nosocomial [hospital-associated or neonatal intensive care unit (NICU)-associated] infections occur in as many as 10 to 36% of very low-birth-weight infants cared for in NICUs.

Objective: To determine the potentially avoidable, incremental costs of care associated with NICU-associated bloodstream infections.

Study design: This retrospective study included all NICU admissions of infants weighing 401 to 1500 g at birth in the greater Cincinnati region from January 1, 2005, through December 31, 2007. Nonphysician costs of care were compared between infants who developed at least one bacterial bloodstream infection prior to NICU discharge or death and infants who did not. Costs were adjusted for clinical and demographic characteristics that are present in the first 3 days of life and are known associates of infection.

Results: Among 900 study infants with no congenital anomaly and no major surgery, 82 (9.1%) developed at least one bacterial bloodstream infection. On average, the cost of NICU care was $16,800 greater per infant who experienced NICU-associated bloodstream infection.

Conclusion: Potentially avoidable costs of care associated with bloodstream infection can be used to justify investments in the reliable implementation of evidence-based interventions designed to prevent these infections.