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Methicillin-resistant Staphylococcus aureus (MRSA) clusters in neonatal intensive care units (NICUs) and other neonatal units in New York State (NYS), 2001 to 2017 - 18/03/24

Doi : 10.1016/j.ajic.2023.09.015 
Karen L. Southwick, MD, MSc a, , Jane Greenko, MPH b, Monica J. Quinn, MS c, Valerie B. Haley, PhD c, d, Eleanor Adams, MD, MPH a, Emily Lutterloh, MD, MPH c, d
a Healthcare Epidemiology and Infection Control Program, New York State Department of Health, New Rochelle, NY 
b Healthcare Epidemiology and Infection Control Program, New York State Department of Health, Central Islip, NY 
c Bureau of Healthcare Associated Infections, New York State Department of Health, Albany, NY 
d Department of Epidemiology and Biostatistics, University at Albany School of Public Health, Albany, NY 

Address correspondence to Karen L. Southwick, MS, MD, New York State Department of Health, 145 Huguenot Street, Suite 603, New Rochelle, NY 10801.New York State Department of Health145 Huguenot Street, Suite 603New RochelleNY10801

Resumen

Background

New York State (NYS) mandates reporting of all hospital-associated communicable disease outbreaks. We describe trends in NYS surveillance for neonatal unit methicillin-resistant Staphylococcus aureus (MRSA) outbreaks, the evolution of national MRSA infection prevention and control (IPC) recommendations, and IPC measures taken by NYS neonatal units.

Methods

We evaluated trends of reported neonatal unit MRSA outbreaks by etiology from 2001 to 2017. We reviewed all reports and the use of IPC recommendations over time.

Results

From 2001 to 2017, 124 MRSA outbreaks were reported in 47 hospital neonatal units, with a total of 1,055 laboratory-confirmed infant cases, 18 infant deaths, and 52 laboratory-confirmed staff cases. The number of outbreaks increased with the level of care. During the study period, a higher proportion of hospitals reported implementing IPC measures, including reinforcing hand hygiene compliance (increased from 79.2% to 95.1%) and enhancing environmental cleaning and disinfection (increased from 4.2% to 78.0%) as well as performing active surveillance testing (AST) on exposed neonates (increased from 4.2% to 51.2%) and molecular testing on MRSA-positive isolates (increased from 5.3% to 18.9%).

Conclusions

From 2001 to 2017, IPC measures in neonatal units increased in parallel with expanded national IPC recommendations. However, MRSA outbreaks in neonatal units continued to be frequent occurrences in NYS.

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Highlights

MRSA neonatal unit outbreaks in all New York hospitals for 17 years.
Infection control responses improved as national MRSA control measures evolved.
Increased use of active surveillance and molecular testing during the study period.
Number of MRSA neonatal unit outbreaks did not change during the study period.

El texto completo de este artículo está disponible en PDF.

Key Words : Nosocomial outbreak, Infection prevention and control, Public health reporting, Multidrug-resistant organism (MDRO), Outbreak surveillance


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 Conflicts of interest: The authors report no conflicts of interest. A co-author was supported by CDC Public Health Emergency Preparedness Cooperative Agreement #NU90TP922009 and CDC Emerging Infections Program Cooperative Agreement #NU50CK000486. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of CDC.


© 2024  Association for Professionals in Infection Control and Epidemiology, Inc.. Publicado por Elsevier Masson SAS. Todos los derechos reservados.
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Vol 52 - N° 4

P. 424-435 - avril 2024 Regresar al número
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