Investigating the Economic Fallout of Hospital-Acquired Infections and Multidrug-Resistant Organisms of Neonatal Sepsis at a Chinese NICU

Introduction: Neonatal sepsis refers to a condition in newborns characterized by systematic inflammation caused by an infection, leading to higher rates of illness and death in neonatal intensive care units worldwide. Despite extensive research on its causes, the financial costs associated with this harmful occurrence, particularly healthcare-associated and multidrug-resistant sepsis in neonatal intensive care units, have not been thoroughly assessed. This study was carried out to estimate the economic consequences of newborn sepsis of newborn sepsis among neonates hospitalized to intensive care units at a general hospital in Taizhou, Zhejiang, China. Methods: : A hospital-based case-control study with retrospective medical records review was conducted among admitted newborns at the neonatal intensive care unit in Taizhou hospital. The study population consisted of 6,507 neonates who were admitted between January 1 st , 2020, and December 31 st , 2022. Among these neonates, we identified 155 cases of sepsis. To ensure comparability, we used the propensity score matching technique to match each septic case with four controls, resulting in a total of 620 controls. We then compared the length of hospitalization and the overall financial burden among neonates with hospital-acquired sepsis (HAI-sepsis), sepsis caused by multidrug resistant organisms (MDRO-sepsis), and those without sepsis. Results: : The overall incidence of neonatal sepsis was 2.4%. Hospital-acquired sepsis (HAI-sepsis) was associated with an additional cost of $6,287 (95% CI: 2,372-11,688), while sepsis caused by multidrug-resistant organisms (MDRO-sepsis) incurred an extra expense of $15,199 (95%CI: 9,450-18,511). Moreover, HAI-sepsis and MDRO-sepsis were found to significantly prolong the length of hospital stay by 31 (95%CI: 16-43), and 41 days (95%CI: 31-50), respectively. Conclusion: This study highlights the substantial financial implications of nosocomial infections. It underscores the importance of implementing antimicrobial stewardship and preventive measures against healthcare associated infections in neonatal intensive care units (NICUs) to effectively reduce healthcare resources utilization and enhance the efficiency of services provided.