Outbreak of methicillin-resistant Staphylococcus aureus in a neonatal intensive care unit

Haddad, Qais; Sobayo, Eunice I.; Basit, O. Bashir Abdel; Rotimi, V.O.

doi:10.1016/0195-6701(93)90026-v

Cited by 52 publications

(24 citation statements)

References 20 publications

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“…Other investigators have shown worse outcomes with higher rates of invasive disease and severe infections and MRSA-related deaths. 4,12,13 On comparison of case-patients with their corre- sponding control-patients, infants with MRSA infection had a significantly increased length of stay, which suggests increased cost. This reinforces previous reports that earlier and successful eradication of outbreaks is cost-effective.…”

Section: Discussionmentioning

confidence: 99%

“…In previously described outbreaks, the use of intranasal mupirocin or fuscidic acid as single agents or in combination with hexachlorophene showers or the combination of trimethoprim-sulfamethoxazole and rifampin was enough to decolonize NICU HCWs. 2,4,12 The adoption of an aggressive approach may be warranted in an effort to achieve earlier control of the spread of MRSA in a NICU. However, although the antibiotics were used for a short time and the likelihood of complications and emergence of resistance was low, this regimen should not be recommended for routine use in similar situations.…”

Section: Discussionmentioning

confidence: 99%

“…3 Implementation of MRSA control efforts in NICUs has been hindered by additional factors such as overcrowding and limited space. 4 Despite variable outcomes of MRSA control measures, early recognition of outbreaks and institution of aggressive infection control measures have been shown to be cost-effective. 5,6 We describe the successful eradication of a hospital-acquired strain of MRSA from a NICU and the infection control methods used to halt an outbreak that had been going on for months, as well as the risk factors for and outcomes of infection or colonization with MRSA.…”

Section: Introductionmentioning

confidence: 99%

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Eradication of Methicillin-ResistantStaphylococcus AureusFrom a Neonatal Intensive Care Unit by Active Surveillance and Aggressive Infection Control Measures

Khoury

Jones²,

Grim³

et al. 2005

Infect. Control Hosp. Epidemiol.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Eradication of Methicillin-ResistantStaphylococcus AureusFrom a Neonatal Intensive Care Unit by Active Surveillance and Aggressive Infection Control Measures

Khoury

Jones²,

Grim³

et al. 2005

Infect. Control Hosp. Epidemiol.

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“…In 1991, a study showed that Saudi and British strains differed in their sensitivity patterns to antibiotics [11]. In Riyadh, it was found that overcrowding of patients and inadequate infection control measures were the major risk factors for MRSA acquisition [12]. In Abha (south region of Saudi Arabia), MRSA accounted for 5.1% of hospital and 18.3% of non-hospital isolates [13].…”

Section: Introductionmentioning

confidence: 99%

Phenotypic and molecular characterization of HA-MRSA in Taif hospitals, Saudi Arabia

Eed

Ghonaim

Hussein

et al. 2015

J Infect Dev Ctries

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Introduction: Methicillin-resistant S. aureus (MRSA) is one of the most important organisms causing hospital-acquired infections worldwide. Molecular analysis of MRSA strains from Taif, Saudi Arabia, had not been previously done. Phenotypic and molecular characteristics of MRSA isolated from Taif hospitals were investigated. Methodology: This study involved S. aureus strains isolated from different clinical samples from Taif hospitals. MRSA strains were identified and antimicrobial susceptibility profiles were determined. Multiplex polymerase chain reaction (PCR) was used to identify S. aureus-specific sequence, mecA genes, and type of staphylococcal cassette chromosome mec (SCCmec). MRSA strains were typed using coagulase gene polymorphism. Results: In total, 390 strains of S. aureus were isolated, and 58 MRSA strains -40 hospital-acquired MRSA (HA-MRSA) and 18 community-acquired MRSA (CA-MRSA) -were detected. HA-MRSA strains included three SCCmec types, while CA-MRSA strains included two SCCmec types. PCR amplification and restriction of the coagulase gene of the 58 MRSA isolates showed nine different patterns, while three strains were non-typable. HA-MRSA strains showed seven distinct restriction fragment length polymorphism (RFLP) patterns; the most frequent was pattern 2 (15 isolates), followed by patterns 1 and 4 (5 isolates each). CA-MRSA showed five RFLP patterns; the most frequent was pattern 3 (7 isolates) followed by pattern 8 (6 isolates). Conclusions: HA-MRSA strains were more common than CA-MRSA strains. SCCmec typing and coagulase gene polymorphism analysis may be useful methods for studying clonal relatedness of isolates and for discriminating between HA-MRSA and CA-MRSA.

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“…[1][2][3] About 70% of Staphylococcus species have been found to be methycillin resistant in the Neonatal Intensive Care Unit of the University Hospital of Sao Bernardo do Campo, Faculty of Medicine of ABC. Vancomycin is the best alternative for these oxacillin-resistant agents.…”

Section: Introductionmentioning

confidence: 99%

Vancomycin Pharmacokinetics in Preterm Infants

Machado

Feferbaum

Kobayashi

et al. 2007

Clinics

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. Vancomycin pharmacokinetics in preterm infants. CLINICS. 2007;62(4):405-10. OBJETIVE:The objective of the present study was to evaluate the kinetic disposition of vancomycin in preterm infants with emphasis on the apparent volume of distribution, biological half-life, and total body clearance as well as whether their variations cause significant modification of the trough plasma concentration of the drug, depending on the postconceptional age (PCA) and the postnatal age (PNA). MATERIAL AND METHOD: Twenty-five selected patients were distributed into 2 groups which differed significantly in terms of mean PCA (31.2-32.3 weeks in group 1, n = 13; 33.5-34.1 weeks in group 2, n = 12: CI95%, P < .001) and PNA (group 1, 12.0-18.5 days; group 2, 18.0-34.0 days, CI95%, P < .05). The parents were informed and signed a written consent for participation of the infants in the protocol that had been previously approved by the Ethics Committee of the hospital. RESULTS: Apparent volume of distribution was significantly increased in group 1 compared with patients of group 2 (0.85 vs. 0.56 L/kg, respectively; P = .01,). Additionally multiple linear regression revealed a good linear correlation (r = 0.85) of trough plasma concentration of vancomycin with the apparent volume of distribution and also with the biological half-life in patients of group 1, while a good correlation (r = 0.91) was obtained for the trough plasma concentration with total body clearance in infants of group 2. The influence of these kinetic parameters on the trough concentration of vancomycin in preterm infants seems to vary according to PCA and PNA. CONCLUSION: In conclusion, the trough plasma concentration of vancomycin depends on the pharmacokinetics, and multiple linear correlation indicates that it varies according to the postconceptional and postnatal age of preterm infants.

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Outbreak of methicillin-resistant Staphylococcus aureus in a neonatal intensive care unit

Cited by 52 publications

References 20 publications

Eradication of Methicillin-ResistantStaphylococcus AureusFrom a Neonatal Intensive Care Unit by Active Surveillance and Aggressive Infection Control Measures

Eradication of Methicillin-ResistantStaphylococcus AureusFrom a Neonatal Intensive Care Unit by Active Surveillance and Aggressive Infection Control Measures

Phenotypic and molecular characterization of HA-MRSA in Taif hospitals, Saudi Arabia

Vancomycin Pharmacokinetics in Preterm Infants

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