Excess Costs of Hospital Care Associated With Neonatal Candidemia
Abstract
BACKGROUND: Nosocomial bloodstream infections are associated with increased hospital costs in adult and pediatric patients. Candida is an increasingly important nosocomial pathogen within intensive care nurseries. The purpose of this study was to determine the attributable cost of candidemia in neonates. METHODS: This case-control study included all neonates with candidemia receiving care in hospitals in Connecticut and in Baltimore County and the city of Baltimore, MD. We identified 47 cases and 130 control patients. Multivariable linear regression was used to control for state, birth weight and mortality to determine the effect of candidemia on length of stay, cost per day and total hospital costs. RESULTS: Candidemia was associated with a $28,000 increase in total hospital costs in multivariable analysis. This increase in total cost was the result of both an increase in costs per day and length of hospital stay. Other cost-increasing variables included in the analysis were: state of origin (Connecticut), survival and decreasing birth weight. CONCLUSIONS: This represents the first study of the adjusted costs of candidemia in neonates. In addition to high mortality, candidemia was associated with increased hospital costs. This cost analysis could be helpful in determining the financial benefits of preventing candidemia in high risk neonates.
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Candidemia is associated with costly hospitalizations, high morbidity, and high all-cause mortality (approximately 25%).
“Candidemia is associated with substantial health care costs, morbidity, and mortality.”
From Population-Based Active Surveillance for Culture-Confirmed Candidemia — 10 Sites, United States, 2017–2021 (2025) · cites this paper as [4]
Cites
Morgan, J., Meltzer, M. I., Plikaytis, B. D., Sofair, A. N., Huie-White, S., Wilcox, S., Harrison, L. H., Seaberg, E. C., Hajjeh, R. A., & Teutsch, S. M. (2005) · Infection Control & Hospital Epidemiology · doi:10.1086/502581 · Cited by 437 · see citing works
Self-citationThe direct cost and incidence of systemic fungal infections
Wilson, L. S., Reyes, C. M., Stolpman, M., Speckman, J., Allen, K., & Beney, J. (2002) · Value in Health · doi:10.1046/j.1524-4733.2002.51108.x · Cited by 374 · see citing works
The Impact of Candidemia on Length of Hospital Stay, Outcome, and Overall Cost of Illness
Rentz, A. M., Halpern, M. T., & Bowden, R. (1998) · Clinical Infectious Diseases · doi:10.1086/514955 · Cited by 310 · cited 2× · see citing works
“These results are consistent with findings in older patients.(8,11,12,22) A survey of 1624 patients with a discharge diagnosis of candidemia identified from the 1993 Nationwide Inpatient Sample found that, compared with uninfected patients, adult patients with candidemia experienced inpatient stays 34 days longer and…”
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Pappas, P. G., Kauffman, C. A., Andes, D. R., Clancy, C. J., Marr, K. A., Ostrosky-Zeichner, L., Reboli, A. C., Schuster, M. G., Vazquez, J. A., Walsh, T. J., et al. (2016) · Clinical Infectious Diseases · doi:10.1093/cid/civ933 · Cited by 4,200 · see citing works
Epidemiology of invasive candidiasis
Arendrup, M. C. (2010) · Current Opinion in Critical Care · doi:10.1097/mcc.0b013e32833e84d2 · Cited by 376 · see citing works
Nosocomial Fungal Infections: Epidemiology, Infection Control, and Prevention
Alangaden, G. J. (2011) · Infectious Disease Clinics of North America · doi:10.1016/j.idc.2010.11.003 · Cited by 337 · see citing works
McCarty, T. P., & Pappas, P. G. (2016) · Infectious Disease Clinics of North America · doi:10.1016/j.idc.2015.10.013 · Cited by 285 · see citing works
The Landscape of Candidemia During the Coronavirus Disease 2019 (COVID-19) Pandemic
Seagle, E. E., Jackson, B. R., Lockhart, S. R., Georgacopoulos, O., Nunnally, N. S., Roland, J., Barter, D. M., Johnston, H. L., Czaja, C. A., Kayalioglu, H., et al. (2022) · Clinical Infectious Diseases · doi:10.1093/cid/ciab562 · Cited by 141 · see citing works
Self-citationZilberberg, M. D., Kollef, M. H., Arnold, H., Labelle, A., Micek, S. T., Kothari, S., & Shorr, A. F. (2010) · BMC Infectious Diseases · doi:10.1186/1471-2334-10-150 · Cited by 128 · see citing works
Zilberberg, M. D., & Shorr, A. F. (2009) · Infectious Disease Clinics of North America · doi:10.1016/j.idc.2009.04.008 · Cited by 42 · see citing works
Jenkins, E. N., Gold, J. A. W., Benedict, K., Lockhart, S. R., Berkow, E. L., Dixon, T., Shack, S. L., Witt, L. S., Harrison, L. H., Seopaul, S., et al. (2025) · MMWR. Surveillance Summaries · doi:10.15585/mmwr.ss7404a1 · Cited by 43 · see citing works
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- Authors
- Smith, P. B., Morgan, J., Benjamin, D. K., Fridkin, S. K., Sanza, L. T., Harrison, L. H., Sofair, A. N., Huie-White, S., & Benjamin, D. K.
- Affiliations
- Duke University (US)
- Centers for Disease Control and Prevention (US)
- Johns Hopkins University (US)
- Corresponding author
- Smith, P Brian
- Venue
- Pediatric Infectious Disease Journal
- Published
- 2007-03
- Volume
- 26
- Issue
- 3
- Pages
- 197-200
- ISSN
- 0891-3668 (ISSN-L)
- OpenAlex
- W2322585225
- Cited by
- 65
- References
- 3
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 1 · 2023: 1 · 2022: 1 · 2021: 2 · 2019: 1 · 2018: 1 · 2017: 2 · 2016: 1 · 2015: 4 · 2014: 4 · 2013: 1 · 2012: 6
- FWCI
- 6.13
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Pediatric Infectious Disease Journal (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Allergy and Infectious Diseases (T32AI052080)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (K23HD044799, HD044799-01)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Neonatal and Maternal Infections
- Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
- Keywords
- neonatal candidemia, hospital costs, nosocomial bloodstream infection, intensive care nursery, length of hospital stay, cost per day, birth weight, neonatal mortality, Candida, economic burden
- MeSH terms
- Candidiasis, Connecticut, Female, Hospitals, Humans, Infant, Newborn, Infant, Newborn, Diseases, Length of Stay, Male, Baltimore, Case-Control Studies, Fungemia, Health Care Costs
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