The Relationship of Nosocomial Infection Reduction to Changes in Neonatal Intensive Care Unit Rates of Bronchopulmonary Dysplasia

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• 作者：Wannasiri Lapcharoensap ; MD¹ ; ² ; ^{lapcharo@ohsu.edu} ; Peiyi Kan ; MS³ ; ⁴ ; Richard J. Powers ; MD⁵ ; Gary M. Shaw ; PhD³ ; ⁴ ; David K. Stevenson ; MD³ ; ⁴ ; Jeffrey B. Gould ; MD ; MPH² ; ³ ; ⁴ ; David D. Wirtschafter ; MD⁶ ; Henry C. Lee ; MD ; MS² ; ³ ; ⁴
• 关键词：neonatal ; quality improvement
• 刊名：The Journal of Pediatrics
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：180
• 期：Complete
• 页码：105-109.e1
• 全文大小：335 K
• 卷排序：180

文摘

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.Study designThis 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.ResultsA 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.ConclusionsSuccessful 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.