ABSTRACT
Recent reports have implicated community-associated methicillin-resistant Staphylococcus aureus (MRSA) as a cause of outbreaks in the neonatal intensive care unit (NICU). This study was conducted to determine whether community-associated MRSA caused such an outbreak in our NICU and the extent of nasal colonization with MRSA among exposed babies and health care workers. MRSA recovered from infected and colonized babies were genotyped by pulse-field gel electrophoresis (PFGE). Infection control measures were intensified and included nasal screening for MRSA colonization of exposed babies and all new admissions to the NICU within 24 hours of delivery. PFGE type A was recovered from five infected infants and colonized 81% of the exposed infants. The colonization rate during the outbreak was 9.3% and was 1.9% during admission screening. No MRSA infection occurred during 12 months while admission screening was implemented. Hospital-associated MRSA was the dominant strain in this outbreak. Higher colonization rates occurred during the outbreak period.
KEYWORDS
MRSA - colonization - neonate
REFERENCES
-
1
Andersen B M, Lindemann R, Bergh K et al..
Spread of methicillin-resistant Staphylococcus aureus in a neonatal intensive care unit associated with understaffing, overcrowding and mixing of patients.
J Hosp Infect.
2002;
50
18-24
-
2
Saiman L, Cronquist A, Wu F et al..
An outbreak of methicillin-resistant Staphylococcus aureus in a neonatal intensive care unit.
Infect Control Hosp Epidemiol.
2003;
24
317-321
-
3
Bratu S, Eramo A, Kopec R et al..
Community-associated methicillin-resistant Staphylococcus aureus in hospital nursery and maternity units.
Emerg Infect Dis.
2005;
11
808-813
-
4 Wesley E K, Tammy L B. Staphylococcus and micrococcus. In: Murray PR, Baron EJ, Pfaller MA, et al Manual of Clinical Microbiology. Washington, DC; ASM Press 2003: 270-273
-
5
Centers for Disease and Control .
Four pediatric deaths from community-acquired methicillin-resistant Staphylococcus aureus—Minnesota and North Dakota, 1997–1999.
Morb Mortal Wkly Rep.
1999;
48
707-710
-
6
Healy C M, Hulten K G, Palazzi D L et al..
Emergence of new strains of methicillin-resistant Staphylococcus aureus in a neonatal intensive care unit.
Clin Infect Dis.
2004;
39
1460-1466
-
7
Regev-Yochay G, Rubinstein E, Barzilai A et al..
Methicillin-resistant Staphylococcus aureus in neonatal intensive care unit.
Emerg Infect Dis.
2005;
11
453-456
-
8
Warren D K, Liao R S, Merz L R et al..
Detection of methicillin-resistant Staphylococcus aureus directly from nasal swab specimens by a real-time PCR assay.
J Clin Microbiol.
2004;
42
5578-5581
-
9
Laibl V R, Sheffield J S, Roberts S et al..
Clinical presentation of community-acquired methicillin-resistant Staphylococcus aureus in pregnancy.
Obstet Gynecol.
2005;
106
461-465
-
10
Stumpf P G, Flores M, Murillo J.
Serious postpartum infection due to MRSA in an asymptomatic carrier: case report and review.
Am J Perinatol.
2008;
25
413-415
-
11
Chen K T, Huard R C, Della-Latta P, Saiman L.
Prevalence of methicillin-sensitive and methicillin-resistant Staphylococcus aureus in pregnant women.
Obstet Gynecol.
2006;
108
482-487
-
12
Chen K T, Campbell H, Borrell L N, Huard R C, Saiman L, Della-Latta P.
Predictors and outcomes for pregnant women with vaginal-rectal carriage of community-associated methicillin-resistant Staphylococcus aureus
.
Am J Perinatol.
2007;
24
235-240
Jeremias L MurilloM.D.
Hospital Epidemiologist, Newark Beth Israel Medical Center
201 Lyons Avenue, Newark, NJ 07112
eMail: jmurillo@sbhcs.com