Document Detail


Seven-year experience with a surveillance program to reduce methicillin-resistant Staphylococcus aureus colonization in a neonatal intensive care unit.
MedLine Citation:
PMID:  19403471     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The objectives of this study were to determine the incidence rates of neonatal methicillin-resistant Staphylococcus aureus colonization and infection after the implementation of a NICU methicillin-resistant S aureus surveillance and isolation program and to describe the characteristics of infants with methicillin-resistant S aureus colonization and invasive disease. METHODS: From August 2000 through August 2007, all infants admitted to the study NICU were screened for methicillin-resistant S aureus colonization with weekly nasal/rectal swabs; colonized or infected infants were isolated and cared for as a cohort. The annual incidence rates of methicillin-resistant S aureus colonization and infection were monitored, and characteristics of methicillin-resistant S aureus-colonized and -infected infants were compared. Data were collected from infant, maternal, and hospital laboratory records. RESULTS: During the study period, 7997 infants were admitted to the NICU and 102 methicillin-resistant S aureus-colonized or -infected infants (1.3%) were identified. The incidence of methicillin-resistant S aureus decreased progressively from 1.79 cases per 1000 patient-days in 2000 to 0.15 cases per 1000 patient-days in 2005, but the incidence then increased to 1.26 cases per 1000 patient-days in 2007. Fifteen of the 102 case infants (14.7%) had invasive infections; no significant differences between infected and colonized infants were identified. Methicillin-resistant S aureus isolates with 14 different antibiograms were found during the study period. There was a shift from isolates predominantly likely to be hospital-associated in 2000-2004 to those likely to be community-associated in 2006-2007. CONCLUSIONS: A continuous program of weekly methicillin-resistant S aureus surveillance cultures and isolation of affected infants was associated with a variable incidence of methicillin-resistant S aureus colonization over a 7-year study period. Methicillin-resistant S aureus was not eradicated from this tertiary-care NICU, and our data suggest that infants were colonized by multiple different methicillin-resistant S aureus strains during the study period.
Authors:
Mary Lucia Gregory; Eric C Eichenwald; Karen M Puopolo
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatrics     Volume:  123     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-04-30     Completed Date:  2009-05-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e790-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Neonatology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Rose Building, Room 318, Boston, MA 02215, USA. mgregory@bidmc.harvard.edu
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MeSH Terms
Descriptor/Qualifier:
Boston / epidemiology
Cross Infection / epidemiology,  prevention & control*
Female
Hospitals, Urban
Humans
Incidence
Infant, Newborn
Intensive Care Units, Neonatal*
Male
Methicillin-Resistant Staphylococcus aureus*
Patient Isolation*
Population Surveillance
Retrospective Studies
Staphylococcal Infections / epidemiology,  prevention & control*

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


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