Socioeconomic Impact on Device Associated Infections in NICUs

July 12, 2011

A study published online this month in the journal Infection presents an analysis of the socioeconomic impact of device-associated infections for limited-resource neonatal intensive care units (NICUs).  The research shows that hospital type and country socioeconomic level influence device-associated healthcare-associated infections (DA-HAIs) and overall mortality in developing countries.

The study involved collecting data from DA-HAIs in NICUs from September 2003 to February 2010.  The data encompassed 13,251 patients from 30 NICUS in 15 countries.  DA-HAIs were defined using Centers for Disease Control and Prevention (CDC) criteria.  Country socioeconomic status was defined using criteria from the World Bank.

Central Line-Associated Blood Stream Infections (CLABSI)

The study results revealed central line-associated bloodstream infection (CLABSI) rates in NICU patients were significantly lower in private hospitals as compared to academic.  However there was no difference in public and academic hospitals.

NICU CLABSI rates were found to be significantly higher in low-income counties as compared to lower-middle-income countries or upper-middle income countries.

Ventilator-Associated Pneumonia (VAP)

The researchers discovered that ventilator-associated pneumonia (VAP) rates for NICU patietns were significantly higher in academic hospitals than those for private or public hospitals.

Lower-middle-income countries had significantly higher VAP rates than those for low-income countries. However, no differences were seen for VAP rates for low-income countries and upper-middle-income countries.

Crude Mortality

When considering hospital type, the overall crude mortality for NICU patients without DA-HAIs was significantly higher in academic and public hospitals than in private hospitals. In contrast, however, the NICU mortality among patients with DA-HAIs was not shown to be different regardless of the hospital type or the country’s socioeconomic level.

Reference:  Rosenthal VD, et al.  Socioeconomic impact on device-associated infections in limited-resource neonatal intensive care units: findings of the INICCInfection, published online July 6, 2011.

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