Polymerase chain reaction-based open reading frame typing (POT) method analysis for a methicillin-resistant Staphylococcus aureus (MRSA) outbreak through breast-feeding in the neonatal intensive care unit

Kato, Hideaki; Ide, Kazuki; Fukase, Fumie; Shimura, Y.; Yasuda, Shuhei; Goto, Hideto; Fukuyama, Ayako; Nakajima, Hitoshi

doi:10.1016/j.idcr.2018.02.005

Cited by 8 publications

(4 citation statements)

References 23 publications

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“…Another known contributor to neonatal HAIs is mothers unpasteurized breast milk that was contaminated with MRSA leading to neonatal HAIs in one of the studies, however, we did not find any such contributors during our study. 31 …”

Section: Discussionmentioning

confidence: 99%

Preventable contributors to the neonatal healthcare-associated infections: a uni-center analytical study from South India.

Rani

Lewis²,

Chawla

et al. 2022

F1000Res

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Background: Globally, neonatal healthcare-associated infections (HAIs) are known to cause high mortality. HAIs is a preventable condition related to the healthcare environment. The current study explored the contributors to neonatal HAIs in one of the largest tertiary care referral hospitals in South India. Methods: Neonates from December 2016 to June 2018 were observed for the occurrence of healthcare-associated infections and compared with the matched control group. Various observations on neonatal demography, maternal contributors, and medical procedures were made and recorded to explore and analyse the contributors to neonatal HAIs. Univariate and multivariate analysis was carried out to find the contributors. The Odds ratio with 95% CI was also computed and reported. Results: Bloodstream infection (83%) was prevalent among neonates; the maternal contributor was only preterm labor (Odds ratio of 11.93; 95% CI; 6.47-21.98; p<.05) to acquire HAIs. On univariate analysis, mechanical ventilation for > 3days duration, NIV for > five days, and PICC line insertion procedure were significant (p<0.05) contributors to neonatal HAIs. IV cannulation for more than three times in four consecutive days was found in 100(85%) neonates considered being associated with neonatal HAIs. On multivariate analysis, NIV, PICC line, preterm labor, and low birth weight were significant (p<0.05) contributors to neonatal HAIs. Conclusion: The increased duration of invasive and non-invasive therapeutic devices and catheters contributes to neonatal HAIs. Neonates are acquiring bloodstream infections; low birth weight (LBW) neonates are more susceptible to acquiring HAIs.

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Section: Discussionmentioning

confidence: 99%

Preventable contributors to the neonatal healthcare-associated infections: a uni-center analytical study from South India.

Rani

Lewis²,

Chawla

et al. 2022

F1000Res

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“…According to the report by Donowitz et al, 23 5 neonates contracted bloodstream infections with K. pneumonia after receiving contaminated raw milk from a single donor. Kato et al 24 described an outbreak of methicillin-resistant S. aureus (MRSA) in a NICU in Japan. Of the 6 neonates on the ward, 5 were colonized with MRSA; 4 of these 5 cases were due to contaminated breast milk.…”

Section: Discussionmentioning

confidence: 99%

Serratia marcescens outbreak in a neonatal intensive care unit associated with contaminated donor milk

Bechmann

Böttger

Baier

et al. 2022

Infect. Control Hosp. Epidemiol.

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Objective: Investigation of the origin of a Serratia marcescens outbreak in a neonatal intensive care unit. Design: Retrospective case–control study. Setting: Regional level 3 perinatal center in Germany. Patients: This study included 4 S. marcescens–positive and 19 S. marcescens–negative neonates treated between February 1 and February 26, 2019, in the neonatal intensive care unit. Methods: A case–control study was performed to identify the source of the outbreak. The molecular investigation of S. marcescens isolates collected during the outbreak was performed using pulsed-field gel electrophoresis and next-generation sequencing. Results: The retrospective case–control study showed a significant correlation (P < .0001) between S. marcensens infection or colonization and consumption of donor milk that had tested negative for pathogenic bacteria from a single breast milk donor. Pulsed-field gel electrophoresis and next-generation sequencing retrospectively confirmed an S. marcescens strain isolated from the breast milk of this donor as the possible origin of the initial outbreak. The outbreak was controlled by the implementation of an infection control bundle including a multidisciplinary infection control team, temporary nutrition of infants with formula only and/or their mother’s own milk, repeated screening of all inpatients, strict coat and glove care, process observation, retraining of hand hygiene and continuous monitoring of environmental cleaning procedures. Conclusions: Low-level contaminated raw donor milk can be a source of infection and colonization of preterm infants with S. marcescens even if it tests negative for bacteria.

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“…Microorganisms are responsible for neonatal sepsis that causes significant morbidity and mortality, especially in preterm infants 10. Contamination of expressed human milk with multiresistant Staphylococcus aureus , extended-spectrum β-lactamase–producing Escherichia coli , and Salmonella enterica has been reported to cause infections in infants receiving treatment in neonatal intensive care units (NICUs), with resultant outbreaks in some units or serious infections such as meningitis 11–13. Therefore, it is vital that necessary steps are taken to minimize contamination and proliferation of pathogenic microorganisms in expressed mothers' milk.…”

Section: Background and Significancementioning

confidence: 99%

“…10 Contamination of expressed human milk with multiresistant Staphylococcus aureus, extended-spectrum β-lactamase-producing Escherichia coli, and Salmonella enterica has been reported to cause infections in infants receiving treatment in neonatal intensive care units (NICUs), with resultant outbreaks in some units or serious infections such as meningitis. [11][12][13] Therefore, it is vital that necessary steps are taken to minimize contamination and proliferation of pathogenic microorganisms in expressed mothers' milk. Processes of expression, storage, transport, and administration to the infant are all potential sources of contamination by infective organisms.…”

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confidence: 99%

Human Milk Expression, Storage, and Transport by Women Whose Infants Are Inpatients at a Tertiary Neonatal Unit in Melbourne, Australia

Rodrigo¹,

Amir

Forster³

et al. 2020

Advances in Neonatal Care

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Background: Expression and storage of mothers' own milk at home and its transportation to hospital neonatal units are a common practice worldwide when newborns are inpatients. Studies assessing adherence to hospital protocols and guidelines for this are not widely published. Purpose: To explore the advice received and practices followed by mothers when expressing, storing, and transporting their milk from home to the hospital, with a substudy exploring the factors related to temperature maintenance of refrigerated milk at recommended values. Methods: Cross-sectional descriptive study at the neonatal intensive care unit of Mercy Hospital for Women, Melbourne, Australia. Mothers who were discharged home after birth of the infant, but whose infant(s) remained in the neonatal unit for 7 days or more participated. All participants completed a self-administered questionnaire. In the substudy, home refrigerator temperature and surface temperature of milk on arrival to the hospital were recorded. Results:The questionnaire was completed by 100 mothers; 38 participated in the substudy. Median travel time from home to the hospital was 32 minutes (range, 2-135 minutes). Lactation consultants were the largest group providing information, with 44 participants (45%) identifying them as the primary information source. Knowledge about recommended refrigerator storage times for expressed milk was correct in 53 mothers (54%). Coolness of milk was better maintained when transported in an insulated food container than nonuse (surface temperature: mean 9.1°C vs 12.2°C; P = .007). Distance and travel duration were not correlated with temperature. Implications for Practice: More diligent monitoring of conditions under which mothers' own milk is transported to hospital is required, and the use of an insulated food container for refrigerated/frozen milk, even for a short duration, should be strongly recommended. Staff to be trained and better equipped to provide uniform, concise information on expressed human milk management to mothers. Implications for Research: Further research to correlate factors associated with transporting human milk expressed at home and infant health outcome is needed.

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Polymerase chain reaction-based open reading frame typing (POT) method analysis for a methicillin-resistant Staphylococcus aureus (MRSA) outbreak through breast-feeding in the neonatal intensive care unit

Cited by 8 publications

References 23 publications

Preventable contributors to the neonatal healthcare-associated infections: a uni-center analytical study from South India.

Preventable contributors to the neonatal healthcare-associated infections: a uni-center analytical study from South India.

Serratia marcescens outbreak in a neonatal intensive care unit associated with contaminated donor milk

Human Milk Expression, Storage, and Transport by Women Whose Infants Are Inpatients at a Tertiary Neonatal Unit in Melbourne, Australia

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