Prolongation of Hospital Stay and Additional Costs Due to Nosocomial Bloodstream Infection in an Algerian Neonatal Care Unit

Abstract

BACKGROUND: Previous studies from developed countries reported that nosocomial bloodstream infection (BSI) in neonatal care units (NCUs) increases length of stay and costs. However, no such information is available for Algerian NCUs. OBJECTIVE: To evaluate the influence of BSI in neonates on additional charges and length of hospital stay. DESIGN: Prospective, nested case-control study. SETTING: The 47-bed NCU of the University Hospital of Blida, Algeria. PATIENTS AND METHODS: A total of 83 neonates with BSIs (case patients) and 166 neonates without BSIs (control patients), admitted to the NCU during the study period (April 2004 through December 2007), were matched for sex, birth weight, length of NCU stay, and year of hospital admission. Each patient's length of stay in the NCU was obtained prospectively on daily rounds. The estimated cost of each NCU-day was provided by the hospital's finance department. The cost of antibiotics prescribed was provided by the hospital's pharmacy department. RESULTS: The mean additional length of NCU stay for case patients, compared with control patients, was 9.2 days (24.3 vs 15.1 days). The mean additional cost of antibiotics was dollars 546. The mean cumulative additional cost was dollars 1,315. CONCLUSION: This study highlights the effect of BSI on extra costs for NCU patients, especially costs due to prolongation of hospital stay and increased antibiotic use, and suggests that NCUs in Algeria have a financial interest in reducing the rate of BSI.