ABSTRACT
@#<p style="text-align: justify;"><strong>OBJECTIVES: </strong>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.</p> <p style="text-align: justify;"><strong>METHODS: </strong>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.</p> <p style="text-align: justify;"><strong>RESULTS: </strong>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.</p> <p style="text-align: justify;"><strong>CONCLUSION: </strong>HAIs were associated with increased cost and duration of hospitalization. These contribute significantly to economic burden to the patient and to hospital resources.</p>
Subject(s)
Humans , Male , Female , Community-Acquired Infections , Infections , Intensive Care Units, Neonatal , Cross Infection , Costs and Cost AnalysisABSTRACT
@#<p style="text-align: justify;"><strong>BACKGROUND:</strong> Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infection is an emerging health problem in pediatrics. Risk factors are not well established in children.<br />OBJECTIVE: To determine the risk factors for the development of methicillin-resistant Staphylococcus aureus infections arising in the community.<br /><strong>METHODOLOGY:</strong> A restrospective case-control study was performed from January 2004 to December 2011. Cases included patients who were culture positive for Staphylococcus aureus and resistant to methicillin/oxacillin while Control included patients who were sensitive to methicillin/oxacillin. The study identified and analyzed the epidemiology, risk factors and resistance pattern of CA-MRSA isolates.<br /><strong>RESULTS:</strong> Three hundred twety three (323) patients with Staphylococcus aureus infections were enrolled: 172 were CA-MRSA infections (cases); and 151 were community acquired methicillin-sensitive Staphylococcus aureus (CA-MSSA) infections (control). Demographic characteristics and clinical profile were skin (cellulitis, furunculosis and abscess) and pulmonary (pneumonica and empyema). The survival rate was high for both groups (>90%). The final multivariate logistic regresion model showed that level of crowding and socio-economic status remained model showed that level of crowding and socio-economic status remained as risk factors for CA-MRSA. The odds of having CA-MRSA in crowded households is 0.35 (90%CI 0.20-0.62) less likely when compared to the odds of acquiring MRSA in less crowded households (p=0.003). Those who had low socio-eonomic had 2.49 times higher chance (90%CI; 1.39 -4.47) of aquiring CA-MRSA compared to those with higher socio-economic status (p=0.01).<br /><strong>CONCLUSION:</strong> CA-MRSA is an emerging problem. This warrants recognition of patients with significant risk factors such as low socio-economic status and level of crowding. This may serve guide in choosing the appropriate antimicrobial theraply.</p>