OBJECTIVES: To determine the impact of hospital-acquired infections (HAI) on the cose and duration of hospitalization among neonatal intensive care unit (NICU) patients from a hospital-based perspective.

METHODS: A case control retrospective study was performed at the 15-bed/crib NICU at PCMC from March 2008 to February 2009. Forty-four neonates who developed HAI while at the NICU were designated as "cases" matched to control subjects (1:1). Control subjects were matched to cases based on gestational age, final diagnosis and date of NICU admission. Eligible cases of HAI were identified retrospectively through the nosocomial infection logbook kept by the Infection Control Nurse. Data collection was done via review of the patient's medical record: gestational age, gender, diagnosis, underlying disease, appropriateness for age, surgical procedure, duration, urgency, classification of surgical intervention, therapeutic procedures prior to first HAI, antibiotic administration prior to diagnosis of first HAI, type of HAI. The length of hospital stay (duration of hospitalization), outcome of the patients and blood isolates of cases of HAI were likewise gathered from the hospital records of each patient. Cost data was obtained from the hospital database.

RESULTS: There was a higher mean cost of hospitalization for NICU patients with HAI Php 275,459 vs 104,407 (USD 5,738 vs USD 2,175). They also had a longer length of stay with a mean of 55.5 days vs 29.3 days. In the analysis using multiple linear regression, the following factors: HAI grouping, length of stay and outcome (mortality) contributed significantly to increased cost.

CONCLUSION: HAIs were associated with increased cost and duration of hospitalization. These contribute significantly to economic burden to the patient and to hospital resources.