title: The investment case for preventing NICU-associated infections.
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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors: Ohio Perinatal Quality Collaborative Executive Committee and James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229-3039, USA. edward.donovan@cchmc.org
authors: Edward F
authors: EF
authors: Donovan
authors: Karen
authors: K
authors: Sparling
authors: Michael R
authors: MR
authors: Lake
authors: Vivek
authors: V
authors: Narendran
authors: Kurt
authors: K
authors: Schibler
authors: Beth
authors: B
authors: Haberman
authors: Barbara
authors: B
authors: Rose
authors: Jareen
authors: J
authors: Meinzen-Derr
mesh_terms: D016470:Bacteremia / Q000191:economics*; D003428:Cross Infection / Q000191:economics*; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal / Q000191:economics* / Q000592:standards; D007902:Length of Stay / Q000706:statistics & numerical data; D015999:Multivariate Analysis; D058996:Quality Improvement / Q000191:economics; D012189:Retrospective Studies