We describe the changing epidemiology of Staphylococcus aureus infections in NICU at Leeds over 2008-2013 using laboratory and clinical data. Method Leeds neonatal service experienced an increased number of cases of Meticillin resistant Staphylococcus aureus (MRSA) colonisation and bacteraemia in [2008][2009]. A series of infection control interventions were implemented stepwise including:• asepsis training.• weekly screening.• adoption of the Saving Lives central venous catheter package, • daily antiseptic skin washes in neonates >28 weeks.• 2% Chlorhexidine for skin asepsis prior to invasive procedures.Results There has been a noticeable success in reduction in MRSA infections and no bacteraemia has been reported since 2009 (Graph 1). A similar improvement has not been seen in Meticillin sensitive Staphylococcus aureus (MSSA) bacteraemia. A retrospective review carried out to review MSSA bacteraemia since 2008: 71% (27 of 38) cases were in neonates under 28 weeks, a vulnerable cohort currently excluded from daily skin washes. Conclusions Given an association between MSSA colonisation and infection, further work should investigate infection control strategies that effectively target the highest risk groups and include active surveillance for MSSA and MRSA with subsequent decolonization.

Background: Duration of antibiotic treatment in neonatal late onset sepsis is empirical.