Document Detail


Epidemiology of methicillin-susceptible Staphylococcus aureus in the neonatal intensive care unit.
MedLine Citation:
PMID:  12452296     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: When the incidence of methicillin-susceptible Staphylococcus aureus (MSSA) infection or colonization increased in our neonatal intensive care unit (NICU), we sought to further our understanding of the relationship among colonization with MSSA, endemic infection, and clonal spread. DESIGN: A retrospective cohort study was used to determine risk factors for acquisition of a predominant clone of MSSA (clone "B"). SETTING: A 45-bed, university-affiliated, level III-IV NICU. PATIENTS: Infants hospitalized in the NICU from October 1999 to September 2000. INTERVENTIONS: Infection control strategies included surveillance cultures of infants, cohorting infected or colonized infants, contact precautions, universal glove use, mupirocin treatment of the anterior nares of all infants in the NICU, and a hexachlorophene bath for infants weighing 1,500 g or more. RESULTS: During the 1-year study period, three periods of increased incidence of MSSA colonization or infection, ranging from 6.4 to 13.5 cases per 1,000 patient-days per month, were observed. Molecular typing using pulsed-field gel electrophoresis demonstrated two predominant clones, clone "B" and clone "G," corresponding to two periods of increased incidence. Multivariate analysis demonstrated that length of stay (OR, 1.035; 95% confidence interval [CI95], 1.008 to 1.062; P = .010) increased risk per day) and the use of H2-blockers (OR, 20.44; CI95, 2.48 to 168.26; P = .005) were risk factors for either colonization or infection with clone "B," and that the use of peripheral catheters was protective (OR, 0.06; CI95, 0.01 to 0.43; P= .005). CONCLUSIONS: Control of MSSA represents unique challenges as colonization is expected, endemic infections are tolerated, and surveillance efforts generally focus on multidrug-resistant pathogens. Future studies should address cost-effective surveillance strategies for endemic infections.
Authors:
Philip L Graham; Anne-Sophie Morel; Juyan Zhou; Fann Wu; Phyllis Della-Latta; David Rubenstein; Lisa Saiman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Infection control and hospital epidemiology : the official journal of the Society of Hospital Epidemiologists of America     Volume:  23     ISSN:  0899-823X     ISO Abbreviation:  Infect Control Hosp Epidemiol     Publication Date:  2002 Nov 
Date Detail:
Created Date:  2002-11-27     Completed Date:  2003-02-25     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  8804099     Medline TA:  Infect Control Hosp Epidemiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  677-82     Citation Subset:  IM; N    
Affiliation:
Department of Pediatrics, Columbia University, New York, NY 10032, USA.
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MeSH Terms
Descriptor/Qualifier:
Cohort Studies
Cross Infection / epidemiology*,  microbiology
Electrophoresis, Gel, Two-Dimensional
Humans
Incidence
Infant, Newborn
Intensive Care Units, Neonatal*
Methicillin Resistance* / genetics
Molecular Epidemiology
New York City / epidemiology
Retrospective Studies
Risk Factors
Sentinel Surveillance
Staphylococcal Infections / epidemiology*,  microbiology
Staphylococcus aureus / genetics,  isolation & purification*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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