Document Detail


Risk factors for neonatal methicillin-resistant Staphylococcus aureus infection in a well-infant nursery.
MedLine Citation:
PMID:  17385145     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine risk factors for neonatal methicillin-resistant Staphylococcus aureus (MRSA) skin and soft-tissue infection in a well-infant nursery. DESIGN: Case-control studies. SETTING: A well-infant nursery in a nonteaching, community hospital. METHODS: Case infants were newborns in the nursery who were born in the period November 2003 through June 2004 and had onset of MRSA skin and soft-tissue infection within 21 days after discharge from the nursery. Site inspections were conducted. Control infants were randomly selected male infants in the nursery during the outbreak periods. MRSA isolates were characterized with pulsed-field gel electrophoresis. RESULTS: Eleven case infants were identified in 2 outbreaks: outbreak 1 occurred from November 18 through December 24, 2003, and outbreak 2 occurred from May 26 through June 5, 2004. All were full-term male infants with pustular-vesicular lesions in the groin. Inspection revealed uncovered circumcision equipment, multiple-dose lidocaine vials, and inadequate hand hygiene practices. In outbreak 1, case infants (n=6) had a significantly higher mean length of stay than control infants (3.7 vs 2.5 days; P=.01). In outbreak 2, case infants (n=5) were more likely to have been circumcised in the nursery (OR, undefined [95% CI, 1.7 to undefined]) and to have received lidocaine injections (OR, undefined [95% CI, 2.6 to undefined]). Controlling for length of stay, case infants were more likely to have been circumcised in the nursery (OR, 12.2 [95% CI, 1.5 to undefined]). Pulsed-field gel electrophoresis showed that 7 available isolates were indistinguishable from a community-associated MRSA strain (USA300-0114). CONCLUSIONS: Newborns in well-infant nurseries are at risk for nosocomial infection with community-associated MRSA strains. Reducing length of stay, improving circumcision and hand hygiene practices, and eliminating use of multiple-dose lidocaine vials should decrease transmission of community-associated MRSA strains in nurseries.
Authors:
Dao M Nguyen; Elizabeth Bancroft; Laurene Mascola; Ramon Guevara; Lori Yasuda
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Publication Detail:
Type:  Journal Article     Date:  2007-03-15
Journal Detail:
Title:  Infection control and hospital epidemiology : the official journal of the Society of Hospital Epidemiologists of America     Volume:  28     ISSN:  0899-823X     ISO Abbreviation:  Infect Control Hosp Epidemiol     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-03-26     Completed Date:  2007-05-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8804099     Medline TA:  Infect Control Hosp Epidemiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  406-11     Citation Subset:  IM; N    
Affiliation:
Center for Disease Control and Prevention, Atlanta, GA, USA. dao.nguyen@kp.org
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MeSH Terms
Descriptor/Qualifier:
Case-Control Studies
Circumcision, Male / methods
Community-Acquired Infections / classification
Cross Infection / etiology*,  prevention & control
Disease Notification
Disease Outbreaks*
Electrophoresis, Gel, Pulsed-Field
Female
Handwashing / standards
Humans
Infant, Newborn
Los Angeles / epidemiology
Male
Methicillin Resistance*
Nurseries, Hospital*
Risk Factors
Staphylococcal Skin Infections / classification,  drug therapy,  etiology*
Staphylococcus aureus / classification,  drug effects*

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


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