title: The Relationship of Nosocomial Infection Reduction to Changes in Neonatal Intensive Care Unit Rates of Bronchopulmonary Dysplasia.
abstract: To examine whether recent reductions in rates of nosocomial infection have contributed to changes in rates of bronchopulmonary dysplasia (BPD) in a population-based cohort.
  
  
  
  This was a retrospective, population-based cohort study that used the California Perinatal Quality Care Collaborative database from 2006 to 2013. Eligible infants included those less than 30 weeks' gestational age and less than 1500 g who survived to 3 days of life. Primary variables of interest were rates of nosocomial infections and BPD. Adjusted rates of nosocomial infections and BPD from a baseline period (2006-2010) were compared with a later period (2011-2013). The correlation of changes in rates across periods for both variables was assessed by hospital of care.
  
  
  
  A total of 22 967 infants from 129 hospitals were included in the study. From the first to second time period, the incidence of nosocomial infections declined from 24.7% to 15% and BPD declined from 35% to 30%. Adjusted hospital rates of BPD and nosocomial infections were correlated positively with a calculated 8% reduction of BPD rates attributable to reductions in nosocomial infections.
  
  
  
  Successful interventions to reduce rates of nosocomial infections may have a positive impact on other comorbidities such as BPD. The prevention of nosocomial infections should be viewed as a significant component in avoiding long-term neonatal morbidities.
authors.affiliation: Department of Pediatrics, Oregon Health & Science University, Portland, OR; California Perinatal Quality Care Collaborative, Stanford, CA. Electronic address: lapcharo@ohsu.edu.
authors.forename: Wannasiri
authors.initials: W
authors.lastname: Lapcharoensap
authors.affiliation: Department of Pediatrics, Stanford University School of Medicine, Stanford, CA; March of Dimes Prematurity Research Center, Stanford, CA.
authors.forename: Peiyi
authors.initials: P
authors.lastname: Kan
authors.affiliation: Pediatrix Medical Group, San Jose, CA.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Powers
authors.affiliation: Department of Pediatrics, Stanford University School of Medicine, Stanford, CA; March of Dimes Prematurity Research Center, Stanford, CA.
authors.forename: Gary M
authors.initials: GM
authors.lastname: Shaw
authors.affiliation: Department of Pediatrics, Stanford University School of Medicine, Stanford, CA; March of Dimes Prematurity Research Center, Stanford, CA.
authors.forename: David K
authors.initials: DK
authors.lastname: Stevenson
authors.affiliation: California Perinatal Quality Care Collaborative, Stanford, CA; Department of Pediatrics, Stanford University School of Medicine, Stanford, CA; March of Dimes Prematurity Research Center, Stanford, CA.
authors.forename: Jeffrey B
authors.initials: JB
authors.lastname: Gould
authors.affiliation: David D. Wirtschafter, Inc, Boca Raton, FL.
authors.forename: David D
authors.initials: DD
authors.lastname: Wirtschafter
authors.affiliation: California Perinatal Quality Care Collaborative, Stanford, CA; Department of Pediatrics, Stanford University School of Medicine, Stanford, CA; March of Dimes Prematurity Research Center, Stanford, CA.
authors.forename: Henry C
authors.initials: HC
authors.lastname: Lee
mesh_terms: D001997:Bronchopulmonary Dysplasia / Q000453:epidemiology* / Q000209:etiology* / Q000517:prevention & control; D015331:Cohort Studies; D003428:Cross Infection / Q000150:complications* / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D012189:Retrospective Studies; D013997:Time Factors
keywords: neonatal; quality improvement