MRSA infection in the neonatal intensive care unit

Giuffrè, Mario; Bonura, Celestino; Cipolla, Domenico; Mammina, Caterina

doi:10.1586/eri.13.28

Cited by 34 publications

(28 citation statements)

References 77 publications

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“…Notably, the current MRSA decolonization protocol largely stems from guidelines for adults [65], and robust evidence regarding its extrapolation to neonates is scarce [70]. Currently, the following questions on MRSA surveillance and decolonization in neonates are yet to be addressed: (1) the implementation of universal versus targeted active surveillance cultures in neonates at high risk for MRSA colonization and infection [10, 64], (2) the definition of optimum surveillance time points to better identify colonized neonates [10, 64], and (3) the benefit of screening extranasal sites for early identification of colonized infants [10, 16, 64]. Moreover, the importance of new screening methods, such as polymerase chain reaction and whole-genome sequencing, needs to be defined [6, 7, 10, 16, 64].…”

Section: Treatment and Prevention Of Neonatal Mrsa Infectionsmentioning

confidence: 99%

“…Currently, the following questions on MRSA surveillance and decolonization in neonates are yet to be addressed: (1) the implementation of universal versus targeted active surveillance cultures in neonates at high risk for MRSA colonization and infection [10, 64], (2) the definition of optimum surveillance time points to better identify colonized neonates [10, 64], and (3) the benefit of screening extranasal sites for early identification of colonized infants [10, 16, 64]. Moreover, the importance of new screening methods, such as polymerase chain reaction and whole-genome sequencing, needs to be defined [6, 7, 10, 16, 64]. Since MRSA resistant to mupirocin and antiseptics have been reported [18, 44, 71], the efficacy of nasal mupirocin application in primary and persistent MRSA decolonization warrants verification [10, 70, 72], Finally, potential adverse effects of antiseptic baths, such as skin irritation and toxicity [73], as well as nonantimicrobial strategies like maternal skin-to-skin contact for MRSA decolonization remain subjects of discussion [74].…”

Section: Treatment and Prevention Of Neonatal Mrsa Infectionsmentioning

confidence: 99%

“…Moreover, the importance of new screening methods, such as polymerase chain reaction and whole-genome sequencing, needs to be defined [6, 7, 10, 16, 64]. Since MRSA resistant to mupirocin and antiseptics have been reported [18, 44, 71], the efficacy of nasal mupirocin application in primary and persistent MRSA decolonization warrants verification [10, 70, 72], Finally, potential adverse effects of antiseptic baths, such as skin irritation and toxicity [73], as well as nonantimicrobial strategies like maternal skin-to-skin contact for MRSA decolonization remain subjects of discussion [74]. …”

Section: Treatment and Prevention Of Neonatal Mrsa Infectionsmentioning

confidence: 99%

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New Threats from an Old Foe: Methicillin-Resistant Staphylococcus aureus Infections in Neonates

2018

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Methicillin-resistant Staphylococcus aureus (MRSA) is a ubiquitous human inhabitant and one of the important pathogens of neonatal infections. MRSA is associated with significant mortality and morbidity, especially in very immature preterm neonates. Moreover, MRSA may be implicated in adverse long-term neonatal outcomes, posing a substantial disease burden. Recent advances in molecular microbiology have shed light on the evolution of MRSA population structure and virulence factors, which may contribute to MRSA epidemic waves worldwide. Equipped with remarkable genetic flexibility, MRSA has successfully developed resistance to an extensive range of antibiotics including vancomycin, as well as antiseptics. In the face of these new challenges from MRSA, our armamentarium of anti-infective strategies is very limited and largely dependent on prevention measures. Active surveillance cultures followed by decolonization may be a promising approach to control MRSA infections, with its efficacy and safety in the specific population of neonates yet to be addressed by large multicenter studies.

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Section: Treatment and Prevention Of Neonatal Mrsa Infectionsmentioning

confidence: 99%

Section: Treatment and Prevention Of Neonatal Mrsa Infectionsmentioning

confidence: 99%

Section: Treatment and Prevention Of Neonatal Mrsa Infectionsmentioning

confidence: 99%

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New Threats from an Old Foe: Methicillin-Resistant Staphylococcus aureus Infections in Neonates

2018

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“…As in other hospital units, methicillin-resistant S. aureus (MRSA) outbreaks have often been reported in NICUs [5-8] whereas, at first glance, methicillin-susceptible S. aureus (MSSA) outbreaks seem less frequent. Indeed, a PubMed database search returns 1108 papers for “MRSA outbreak” versus 52 for “MSSA outbreak” (January 2014).…”

Section: Introductionmentioning

confidence: 99%

Staphylococcus aureus in a neonatal care center: methicillin-susceptible strains should be a main concern

Romano-Bertrand

Filleron

Mesnage

et al. 2014

Antimicrob Resist Infect Control

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BackgroundIn the context of a methicillin-susceptible Staphylococcus aureus (MSSA) outbreak, we aimed to improve our knowledge of S. aureus (SA) epidemiology in the neonatal care center (NCC) of a tertiary care teaching hospital.MethodsWe performed a complete one-year review of SA carrier, colonized or infected patients. Monthly prevalence and incidence of SA intestinal carriage, colonization and infection were calculated and the types of infection analysed. During the MSSA outbreak, strains were studied for antimicrobial resistance, content of virulence genes and comparative fingerprint in Pulsed-Field Gel Electrophoresis. Hand hygiene and catheter-related practices were assessed by direct observational audits. Environmental investigation was performed in search of a SA reservoir.ResultsEpidemiological analyses showed 2 or 3 prevalence peaks on a background of SA endemicity. In the NCC, during 2009, overall MSSA prevalence did not decrease below 5.5%, while mean MRSA prevalence was about 1.53%. Analysis of infection cases revealed that the outbreak corresponded to the emergence of catheter-related infections and was probably related to the relaxation in infection control practices in a context of high colonization pressure. Health care workers’ white coats appeared as a potential environmental reservoir that could perpetuate SA circulation in the ward.ConclusionThis report emphasizes the importance of integrating MSSA along with methicillin-resistant SA in a program of epidemiological surveillance in the NCC.

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“…CA-MRSA strains have been reported as a cause of colonization and infection in neonatal intensive care units in many countries [16, 17]. …”

Section: Discussionmentioning

confidence: 99%

Genotyping of Methicillin ResistantStaphylococcus aureusStrains Isolated from Hospitalized Children

Nejma

Merghni

Mastouri

2014

International Journal of Pediatrics

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Community associated methicillin resistant Staphylococcus aureus (CA-MRSA) is an emerging pathogen increasingly reported to cause skin and soft tissue infections for children. The emergence of highly virulencet CA-MRSA strains in the immunodeficiency of young children seemed to be the basic explanation of the increased incidence of CA-MRSA infections among this population. The subjects of this study were 8 patients hospitalized in the Pediatric Department at the University Hospital of Monastir. The patients were young children (aged from 12 days to 18 months) who were suffering from MRSA skin infections; two of them had the infections within 72 h of their admission. The isolates were classified as community isolates as they all carried the staphylococcal cassette chromosome mec (SCCmec) IV and pvl genes. Epidemiological techniques, pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST), were applied to investigate CA-MRSA strains. Analysis of molecular data revealed that MRSA strains were related according to PFGE patterns and they belonged to a single clone ST80. Antimicrobial susceptibility tests showed that all strains were resistant to kanamycin and 2 strains were resistant to erythromycin.

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MRSA infection in the neonatal intensive care unit

Cited by 34 publications

References 77 publications

New Threats from an Old Foe: Methicillin-Resistant <b><i>Staphylococcus aureus</i></b> Infections in Neonates

New Threats from an Old Foe: Methicillin-Resistant <b><i>Staphylococcus aureus</i></b> Infections in Neonates

Staphylococcus aureus in a neonatal care center: methicillin-susceptible strains should be a main concern

Genotyping of Methicillin ResistantStaphylococcus aureusStrains Isolated from Hospitalized Children

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