scholarly journals Decolonization to prevent Staphylococcus aureus transmission and infections in the neonatal intensive care unit

2014 ◽  
Vol 34 (11) ◽  
pp. 805-810 ◽  
Author(s):  
V O Popoola ◽  
A M Milstone
Keyword(s):  
Intensive Care Unit ◽  
Staphylococcus Aureus ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care

An Outbreak of Methicillin-Resistant Staphylococcus aureus in a Neonatal Intensive Care Unit

2003 ◽  
Vol 24 (5) ◽  
pp. 317-321 ◽  
Author(s):  
Lisa Saiman ◽  
Alicia Cronquist ◽  
Fann Wu ◽  
Juyan Zhou ◽  
David Rubenstein ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Staphylococcus Aureus ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Methicillin Resistant ◽  
Children's Hospital ◽  
Surveillance Cultures ◽  
Children’S Hospital ◽  
Incident Cases

AbstractObjective:To describe the epidemiologic and molecular investigations that successfully contained an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) in a neonatal intensive care unit (NICU).Design:Isolates of MRSA were typed by pulsed-field gel electrophoresis (PFGE) and S. aureus protein A (spa).Setting:A level III-IV, 45-bed NICU located in a children's hospital within a medical center.Patients:Incident cases had MRSA isolated from clinical cultures (eg, blood) or surveillance cultures (ie, anterior nares).Interventions:Infected and colonized infants were placed on contact precautions, cohorted, and treated with mupirocin. Surveillance cultures were performed for healthcare workers (HCWs). Colonized HCWs were treated with topical mupirocin and hexachlorophene showers.Results:From January to March 2001, the outbreak strain of MRSA PFGE clone B, was harbored by 13 infants. Three (1.3%) of 235 HCWs were colonized with MRSA. Two HCWs, who rotated between the adult and the pediatric facility, harbored clone C. One HCW, who exclusively worked in the children's hospital, was colonized with clone B. From January 1999 to November 2000, 22 patients hospitalized in the adult facility were infected or colonized with clone B. Spa typing and PFGE yielded concordant results. PFGE clone B was identified as spa type 16, associated with outbreaks in Brazil and Hungary.Conclusions:A possible route of MRSA transmission was elucidated by molecular typing. MRSA appears to have been transferred from our adult facility to our pediatric facility by a rotating HCW. Spa typing allowed comparison of our institution's MRSA strains with previously characterized outbreak clones.

scholarly journals Surveillance-embedded genomic outbreak resolution of methicillin-susceptible Staphylococcus aureus in a neonatal intensive care unit

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
A. J. H. Cremers ◽  
J. P. M. Coolen ◽  
C. P. Bleeker-Rovers ◽  
A. D. J. van der Geest-Blankert ◽  
D. Haverkate ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Staphylococcus Aureus ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care

scholarly journals 464. Fecal Staphylococcus aureus in the Neonatal Intensive Care Unit

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S227-S227
Author(s):  
Mike Carl ◽  
Olivia Milburn ◽  
Emma Uible ◽  
David Haslam
Keyword(s):  
Intensive Care Unit ◽  
Staphylococcus Aureus ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Sensitivity And Specificity ◽  
Neonatal Intensive Care ◽  
Severe Disease ◽  
Metagenomic Sequencing ◽  
Shotgun Metagenomics ◽  
Stool Samples

Abstract Background Staphylococcus aureus colonization in infants in the neonatal intensive care unit (NICU) often leads to repeated infections and severe disease. Methicillin-resistant S. aureus (MRSA) and methicillin-sensitive S. aureus (MSSA) infections are major causes of NICU outbreaks. Current national practice in NICUs utilizes nare swab surveillance for S. aureus. We hypothesize that infants colonized in the stool with S. aureus may go unrecognized particularly when nare swab negative, allowing for a transmission reservoir. While it is unclear why some S. aureus nare carriers are also stool colonized, isolates tend to have clonality. A true prevalence of S. aureus fecal carriage is not well understood and variable. Methods Available stool samples were prospectively collected from 42 of 55 infants admitted in a level IV NICU on a single day, per Cincinnati Children’s institutional review board approval. Nare swab results were obtained from electronic medical records. DNA was isolated from stool and shotgun metagenomic sequencing was performed via Hiseq Illuminex 2500. The presence of S. aureus and MRSA were defined as having >100 sequencing reads and a mecA DNA read fraction ratio >40 per stool sample, respectively. Results Of the 42 stool samples sequenced, 33 were S. aureus (15 MSSA, 18 MRSA) positive. All infants with nare positive MSSA (n = 9) were colonized in the stool with a 93% and 100% sensitivity and specificity, respectively. While infants with nare positive MRSA (n = 10) were stool colonized with 100% and 83% sensitivity and specificity, respectively. Three nare positive infants with MRSA had S.a. in the stool but lacked the presence of mecA. When comparing clinical nare swabs to stool metagenomic surveillance, sensitivities were 60% for MSSA and 56% for MRSA. Conclusion Infant colonization of S. aureus in the NICU remains a major problem despite current national surveillance and isolation practices. We found that nare swab surveillance for S. aureus in infants significantly underestimated colonization rates when compared with shotgun metagenomics of stool. These results suggest that nare swabs alone may not have adequate sensitivity and the implementation of stool surveillance should be considered to augment current practices. Future study is necessary to understand how the S. aureus stool reservoir contributes to transmission Disclosures All authors: No reported disclosures.

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