Impact of MRSA Transmission and Infection in a Neonatal Intensive Care Unit in China: A Bundle Intervention Study during 2014-2017

Abstract

Objective. To evaluate the efficacy of bundle intervention on healthcare-associated (HA) methicillin-resistant Staphylococcus Aureus (MRSA) infection in the neonatal intensive care unit (NICU). Methods. In this study, 11,277 infants having undergone treatment at the NICU in Xiamen, China, from January 2014 to February 2017 were recruited. We retrospectively reviewed patients’ demographic and clinical information. Patients from 2014 to 2015 were treated as the control group and those from 2016 to 2017 were classified as the experimental group. Bundle intervention measures were performed, including screening for MRSA, isolation precautions, training of hand hygiene, cleaning protocols, and decontamination of isolation ward. The HA-MRSA data and compliance of infection control measures between both groups were analyzed. Results. Through bundle interventions, the compliance with the isolation of MRSA raised from 55.88% to 92.86% and hand hygiene compliance increased from 90.07% to 93.23% (P < 0.05). The HA infection decreased from 1.87% to 1.71% (P > 0.05) and HA detection rate of MRSA declined from 2.63‰ to 1.00‰, respectively (P < 0.05). Conclusion. Multifaceted interventions can effectively prevent MRSA infection and transmission; this includes active surveillance, isolation precautions, increased hand hygiene compliance, environmental cleaning, and decontamination.

Infection prevention and care bundles addressing health care-associated infections in neonatal care in low-middle income countries: a scoping review

“…The most common terms used in the publications to name the care bundles were 'measures' (13, 30%), 24,26,31,40,43,49,50,53,55,[57][58][59]61 followed by 'bundles' (nine, 21%). 20,23,27,30,34,35,37,41,47 (Figure 2).…”

“…The studies reported data from 55 LMIC, with India and China being most commonly represented ( Table 1 ). [20] , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 Regarding study design, 24 (55%) were uncontrolled before-after, 20 , 21 , 23 , 25 , 26 , 27 , 28 , 29 , 30 , 32 , [33] , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 36 , 43 , 44 , 45 , 46 and two (5%) were interrupted time series. 47 , 48 The rest were retrospective outbreak investigation studies.…”

“…The most common terms used in the publications to name the care bundles were ‘measures’ (13, 30%), 24 , 26 , 31 , 40 , 43 , 49 , 50 , 53 , 55 , 57 , 58 , 59 , 61 followed by ‘bundles’ (nine, 21%). 20 , 23 , 27 , 30 , 34 , 35 , 37 , 41 , 47 ( Figure 2 ).

Figure 2 Word cloud with the terminology used to name the care bundles.

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“… 36 , 62 , 63 Two elements were focused on introducing new screening programmes. 30 , 46 No bundles were exclusively made up of detection elements. Subsequently, bundles containing some detection elements were allocated to Type 5 ( composite ).…”

Understanding the Trend and Distribution of Antimicrobial Resistance Using Event Based Surveillance System: EpiWatch

“…All VRE cases were reported from hospital wards. The ability of MRSA and VRE to spread from hospital environment to the patients as well as from other infected or colonised patients/ health care workers (14,15), coupled with immature immunologic functions in neonates (15), explains the frequent outbreaks in neonatal wards. Crowded schools and universities might create an environment to facilitate the spread of MRSA (16).…”