Objective: Examine variation in incidence of neonatal NBSIs among six NICUs and in relation to population characteristics, admission illness severity, and length of stay (LOS).

Methods: From Oct 94 to June 96, six regional NICUs prospectively abstracted clinical data about all neonates weighing < 1500 grams. Illness severity was assessed at admission by the Score for Neonatal Acute Physiology(SNAP). Occurrence of NBSIs, defined as first positive culture after 48 hours, was analyzed in relation to admission BW, GA, SNAP score, institution, and LOS.

Results: There were 258 NBSIs (incidence=19.1%) among 1354 inborn first admissions. Shown below are NBSIs per 100 admissions with SD in relation to BW:

Variation remained significant (p<0.05, Chi-square) after stratifying by BW, GA and SNAP. Variation between sites remained substantial even when using survival analyses to adjust for inter-institutional differences in LOS.

Conclusion: Neonatal NBSI incidence varies substantially among institutions despite adjustment for baseline population risk, admission illness severity and LOS. Further studies will explore the relationship between NBSI incidence and clinical practice patterns. Table

Table 1 No caption available.
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