Surveillance for Colonization, Transmission, and Infection With Methicillin-Susceptible Staphylococcus aureus in a Neonatal Intensive Care Unit

Abstract

Key Points Question What are the risk factors for the acquisition of methicillin-susceptible Staphylococcus aureus (MSSA) colonization and infections in a neonatal intensive care unit? Findings In this cohort study of 590 newborns, the acquisition of S aureus colonization and infection was monitored until hospital discharge. Colonization with MSSA was associated with lower birth weight, longer hospitalization, and higher odds of acquiring S aureus infection during hospitalization. Meaning These findings suggest that nasal colonization is a relevant risk factor for MSSA infection in a nonoutbreak neonatal intensive care unit setting.

Colonization of Extended-spectrum β-lactamase producing Enterobacterales and meticillin-resistant S. aureus in the intensive care unit at a tertiary hospital in Tanzania: Implications for Infection control and prevention

“…The finding indicates that most patients were at risk of contracting ESBL-PE infections during their course of admission to the ICU. As previous studies have shown, colonization with resistant bacteria is the pre-request for subsequent infections [ 3 , 31 ]. On the other hand, the high carriage we have observed in these patients at admission indicates a high risk of spreading ESBL-PE to other patients admitted to the ICU.…”

“…Antibiotic use exerts selective pressure leading to the overgrowth of resistant bacterial populations (endogenous colonization). Theoretically, colonization of patients with these pathogens is the prerequisite for subsequent invasive disease [ 3 ], and infections in ICU result in significant morbidity, mortality, and high healthcare costs [ 2 , 4 ].…”

“…Globally, MRSA and vancomycin-resistant enterococci (VRE) are the most common Gram-positive resistant microorganisms causing infection in ICU patients [ [3] , [4] , [5] , [6] ], whereas resistance in Gram-negative bacteria is primarily due to the rapid increase of ESBL-PE and MDR in Pseudomonas aeruginosa , Acinetobacter spp , and Stenotrophomonas maltophilia [ [6] , [7] , [8] ]. In addition, studies have revealed an increase in ESBL-PE and MDR bacteria in Africa, causing healthcare-acquired infections in ICU [ [9] , [10] , [11] , [12] ].…”

Whole-genome sequencing enhances existing pathogen and antimicrobial-resistance surveillance schemes within a neonatal unit

“…As sequencing capacity and expertise within the clinical realm continues to expand, it is interesting to reflect on whether near real-time availability of sequencing results would have enabled establishment of transmission routes with greater certainty, and afforded the opportunity to reduce or eliminate the transmission risk. A recent study of Staphylococcus aureus infection and colonization within a German neonatal unit similarly showed evidence of frequent transmission events occurring in spite of regular screening and enhanced infection prevention and control measures [26].…”

Utility of Methicillin-Resistant Staphylococcus aureus Nares Screening in Hospitalized Children with Acute Infectious Disease Syndromes

“…Studies in pediatric patients have thus far focused mostly on determining S. aureus- and MRSA-colonization rates, especially in patients receiving care in the neonatal intensive care environment as well as pre-operatively [ 8 , 9 ]. Studies evaluating MNS in children admitted for presumed infectious disease diagnoses are lacking.…”