Methicillin-resistant Staphylococcus aureus nasal colonization in a level III neonatal intensive care unit: Incidence and risk factors - 04/05/15
Abstract |
Objective |
To describe epidemiologic features and identify risk factors for methicillin-resistant Staphylococcus aureus (MRSA) acquisition in a level III neonatal intensive care unit (NICU).
Setting |
A prospective, cohort study in a university-affiliated NICU with an infection control program including weekly nasal cultures of all neonates.
Methods |
Demographic, clinical, and microbiologic data were prospectively collected between June 2009 and June 2013. Molecular characterization of MRSA isolates was done by multilocus variable number tandem repeat fingerprinting, staphylococcal cassette chromosome mec typing, and on representative isolates by multilocus sequence typing and spa typing.
Results |
Of 949 neonates, 217 (22.87%) had a culture growing MRSA, including 117 neonates testing positive at their first sampling. Of these latter infants, 96 (82.05%) were inborn and 59 (50.43%) had been transferred from the nursery. Length of stay and colonization pressure were strong independent predictors of MRSA acquisition. Among MRSA isolates, 7 sequence types were identified, with ST22-IVa, spa type t223, being the predominant strain.
Conclusions |
In an endemic area, early MRSA acquisition and high colonization pressure, likely related to an influx of colonized infants from a well-infant nursery, can support persistence of MRSA in NICUs. Surveillance, molecular tracking of strains, and reinforcement of infection control practices, involving well-infant nurseries in a comprehensive infection control program, could be helpful in containing MRSA transmission.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Methicillin resistant Staphylococcus aureus (MRSA) is a major agent of infectious disease in neonatal intensive care units (NICUs) |
• | A level III NICU with an associated surgery unit and a high proportion of malformation can be critically exposed to the risk of becoming endemic for MRSA |
• | Neonates transferred from the nursery to NICU may play a prominent role in the transmission chain |
• | In a high endemic area, the infection control progress in a NICU can be seriously hindered by the multiple entering routes of MRSA |
Key Words : Colonization pressure, Active surveillance, Infection control
Plan
| Conflicts of interest: None to report. |
Vol 43 - N° 5
P. 476-481 - mai 2015 Retour au numéro
Article précédent
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