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Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)
12:18

Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)

Published on: February 9, 2011

Staphylococcus aureus, including community-acquired methicillin-resistant S. aureus, in a level III NICU: 2001 to

Divya Rana1, Nazha Abughali, Deepak Kumar

  • 1Department of Pediatrics, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH 44109, USA.

American Journal of Perinatology
|March 9, 2012
PubMed
Abstract

Insights

The incidence of methicillin-resistant Staphylococcus aureus (MRSA) nearly doubled in neonatal intensive care units, coinciding with the emergence of the community-acquired MRSA USA300 strain. Methicillin-susceptible S. aureus (MSSA) rates declined during the same period.

Area of Science:

  • Neonatal Intensive Care Unit (NICU) epidemiology
  • Infectious disease surveillance
  • Bacterial resistance patterns

Background:

  • Staphylococcus aureus is a common cause of neonatal infections.
  • Distinguishing between methicillin-susceptible (MSSA) and methicillin-resistant (MRSA) strains is crucial for treatment and understanding epidemiology.
  • Neonatal intensive care units are vulnerable settings for healthcare-associated infections.

Purpose of the Study:

  • To investigate the epidemiology and clinical features of S. aureus infections in a level III NICU.
  • To compare outcomes and trends of MSSA versus MRSA in neonates.
  • To identify factors associated with MRSA emergence in the NICU.

Main Methods:

  • Retrospective cohort study of all NICU admissions from 2001 to 2008.
  • Inclusion of all infants with positive S. aureus cultures.
  • Classification of cases as colonized, infected, or with invasive disease.

Main Results:

  • S. aureus was identified in 6.3% of admitted infants (273/4304), with 198 MSSA and 75 MRSA cases.
  • The incidence of MRSA cultures (colonization and invasive disease) increased significantly from 13.7 to 24.77 per 1000 admissions between 2001-2005 and 2006-2008 (p=0.010).
  • Conversely, MSSA culture incidence decreased (p=0.044). Invasive disease rates remained similar for both MSSA and MRSA.
  • Infants with invasive MRSA had a longer duration of positive cultures (55 vs. 19 days, p=0.009).
  • The USA300 strain, associated with community-acquired MRSA, emerged during the later study period.

Conclusions:

  • MRSA colonization and infection nearly doubled during the study period.
  • The rise in MRSA coincided with the emergence of the community-acquired MRSA USA300 strain.
  • These findings highlight the changing landscape of S. aureus epidemiology in NICUs.

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