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Eradication of methicillin-resistant Staphylococcus aureus from a neonatal intensive care unit by active surveillance

Jad Khoury1, Marilyn Jones, Autumn Grim

  • 1Department of Internal Medicine, Division of Infectious Diseases, Washington University School of Medicine, St. Louis, Missouri 63110, USA.

Infection Control and Hospital Epidemiology
|August 12, 2005
PubMed
Abstract

Insights

An outbreak of Methicillin-resistant Staphylococcus aureus (MRSA) in a NICU was controlled using active surveillance, isolation, and decolonization. This strategy effectively eliminated MRSA for over two years, improving patient outcomes.

Area of Science:

  • Infectious Diseases
  • Neonatal Care
  • Hospital Epidemiology

Background:

  • Hospital-acquired infections, particularly Methicillin-resistant Staphylococcus aureus (MRSA), pose a significant threat in Neonatal Intensive Care Units (NICUs).
  • Understanding the specific risk factors and outcomes associated with MRSA in this vulnerable population is crucial for effective control.

Purpose of the Study:

  • To document a hospital-acquired MRSA outbreak in a NICU.
  • To identify risk factors, clinical outcomes, and successful interventions for MRSA elimination.

Main Methods:

  • A case-control study was conducted in an 18-bed level III-IV NICU.
  • Interventions included active surveillance, contact isolation, cohorting, and decolonization of infants and healthcare workers (HCWs).
  • Molecular typing (Rep-PCR, mec typing, PVL analysis) confirmed the MRSA strain.

Main Results:

  • An outbreak with an increased MRSA attack rate (21.2%) was observed.
  • Risk factors for MRSA colonization/infection included low birth weight, younger gestational age, multiple gestation, gavage feeding, and intubation.
  • Infants with MRSA infection experienced significantly longer hospital stays (51.83 vs 21.46 days).

Conclusions:

  • A combination of active surveillance, aggressive contact isolation, cohorting, and decolonization effectively eradicated MRSA from the NICU.
  • The implemented interventions maintained MRSA absence for 2.5 years post-outbreak.
  • This multidisciplinary approach is vital for controlling MRSA in NICU settings.

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