Methicillin-Resistant Staphylococcus aureus in the Neonatal Intensive Care Unit

Nelson, Melissa U.; Gallagher, Patrick G.

doi:10.1053/j.semperi.2012.06.004

Cited by 76 publications

(68 citation statements)

References 43 publications

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“…Data from different studies in NICU population report, despite variations in prevalence measurements, a rate of colonized or infected neonates with MRSA between 0.6% and 8.4% [19]. The epidemiology of MRSA is changing from being exclusively a hospital acquired pathogen to a pathogen with widespread distribution in the community [20,21].…”

Section: Gram Positive Bacteriamentioning

confidence: 99%

Neonatal infections due to multi-resistant strains: Epidemiology, current treatment, emerging therapeutic approaches and prevention

Tzialla

Borghesi

Pozzi

et al. 2015

Clinica Chimica Acta

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Section: Gram Positive Bacteriamentioning

confidence: 99%

Neonatal infections due to multi-resistant strains: Epidemiology, current treatment, emerging therapeutic approaches and prevention

Tzialla

Borghesi

Pozzi

et al. 2015

Clinica Chimica Acta

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“…1,2 These infections are largely preceded by colonization with MRSA 3 ; and colonized children serve as a reservoir for the cross-transmission of MRSA and are frequently identified as sources of outbreaks in the NICU and PICU settings. 4 A number of reports indicate that the trends in MRSA invasive infections in high-risk adult populations are decreasing.…”

mentioning

confidence: 99%

MRSA Colonization and Risk of Infection in the Neonatal and Pediatric ICU: A Meta-analysis

Zervou

Zacharioudakis

Ziakas³

et al. 2014

Pediatrics

110

102

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BACKGROUND AND OBJECTIVE: Methicillin-resistant Staphylococcus aureus (MRSA) is a significant cause of morbidity and mortality in NICUs and PICUs. Our objective was to assess the burden of MRSA colonization on admission, study the time trends, and examine the significance of MRSA colonization in this population. METHODS:PubMed and Embase databases were consulted. Studies that reported prevalence of MRSA colonization on ICU admission were selected. Two authors independently extracted data on MRSA colonization and infection. RESULTS:We identified 18 suitable articles and found an overall prevalence of MRSA colonization of 1.9% (95% confidence interval [CI] 1.3%-2.6%) on admission to the NICU or PICU, with a stable trend over the past 12 years. Interestingly, 5.8% (95% CI 1.9%-11.4%) of outborn neonates were colonized with MRSA on admission to NICU, compared with just 0.2% (95% CI 0.0%-0.9%) of inborn neonates (P = .01). The pooled acquisition rate of MRSA colonization was 4.1% (95% CI 1.2%-8.6%) during the NICU and PICU stay and was as high as 6.1% (95% CI 2.8%-10.6%) when the NICU population was studied alone. There was a relative risk of 24.2 (95% CI 8.9-66.0) for colonized patients to develop a MRSA infection during hospitalization. CONCLUSIONS:In the NICU and PICU, there are carriers of MRSA on admission, and MRSA colonization in the NICU is almost exclusively associated with outborn neonates. Importantly, despite infection control measures, the acquisition rate is high, and patients colonized with MRSA on admission are more likely to suffer a MRSA infection during hospitalization.

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“…ethicillin-resistant Staphylococcus aureus (MRSA) is a common etiology of life-threatening, health care-associated (HA) infection in neonatal intensive care units (NICU) (1,2). The National Nosocomial Infections Surveillance System observed a Ͼ300% increase in the incidence of late-onset MRSA infections in NICUs, from 0.7 to 3.1 infections/10,000 patient days, between 1995 and 2004 (3).…”

mentioning

confidence: 99%

Clinical and Molecular Epidemiology of Methicillin-Resistant Staphylococcus aureus in a Neonatal Intensive Care Unit in the Decade following Implementation of an Active Detection and Isolation Program

et al. 2015

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1, 2). The National Nosocomial Infections Surveillance System observed a Ͼ300% increase in the incidence of late-onset MRSA infections in NICUs, from 0.7 to 3.1 infections/10,000 patient days, between 1995 and 2004 (3). Unique host and environmental factors, including immature immune systems, high frequency of contact with health care providers (4), exposure to numerous invasive procedures, NICU overcrowding and understaffing (5, 6), and prolonged hospitalization (7), make NICU patients at especially high risk of becoming colonized and infected with MRSA. Since colonization with MRSA is a risk factor for development of MRSA infection, prevention of MRSA transmission within the NICU is critical (7,8). Many NICUs have implemented active detection and isolation (ADI) programs, which involve surveillance to rapidly identify affected patients, followed by cohorting and isolation with standard contact precautions, in attempts to prevent MRSA transmission and reduce infection rates.Several large NICUs have published reports regarding the clinical epidemiology of neonatal MRSA following implementation of surveillance, transmission prevention, and/or decolonization strategies (7,(9)(10)(11)(12). Some also incorporated molecular analyses in their studies, including antibiotic susceptibility testing (9, 10), strain typing (9, 11, 12), genotyping (9, 12), and/or Panton-Valentine leukocidin gene detection (9,12). No studies have comprehensively examined all of those molecular features of MRSA and additionally assessed the presence or absence of genes encoding proteins for a variety of staphylococcal toxins and potential virulence factors over an extensive time period following implementation of an ADI program in an NICU.In response to the appearance of MRSA in the NICU at YaleNew Haven Children's Hospital (YNHCH)

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Methicillin-Resistant Staphylococcus aureus in the Neonatal Intensive Care Unit

Cited by 76 publications

References 43 publications

Neonatal infections due to multi-resistant strains: Epidemiology, current treatment, emerging therapeutic approaches and prevention

Neonatal infections due to multi-resistant strains: Epidemiology, current treatment, emerging therapeutic approaches and prevention

MRSA Colonization and Risk of Infection in the Neonatal and Pediatric ICU: A Meta-analysis

Clinical and Molecular Epidemiology of Methicillin-Resistant Staphylococcus aureus in a Neonatal Intensive Care Unit in the Decade following Implementation of an Active Detection and Isolation Program

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