Related Experiment Video
Updated: May 21, 2026
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)
Published on: February 9, 2011
Epidemic spread of ST1-MRSA-IVa in a neonatal intensive care unit, Italy
Mario Giuffrè1, Domenico Cipolla, Celestino Bonura
1Department of Mother and Child, University of Palermo, Palermo, Italy.
Background:
Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has recently emerged as an important pathogen in neonatal intensive care units (NICUs). The purposes of this study were to characterize methicillin-resistant isolates from an outbreak in a NICU, to examine the genetic traits and clonality of CA-MRSA, and to review the characteristics and outcomes of the neonatal cases and investigate the routes of entry and transmission of the MRSA outbreak strain in the NICU under study.
Methods:
The study NICU practiced an active surveillance program for multidrug-resistant organisms, including weekly cultures for detection of MRSA from nasal swabs among all the admitted neonates. All first isolates from surveillance cultures and all clinical isolates were submitted for susceptibility testing and genotyping. Data from each infant's medical records were prospectively included in a database, and the clinical features and outcomes of the colonized/infected infants were assessed.
Results:
A total of 14 infants were colonized or infected by a strain of ST1-MRSA-IVa between April and August 2011. The CA-MRSA strain appeared to have been introduced to the NICU by an infected infant transferred from another hospital. The outbreak was successfully contained by multifaceted infection control interventions.
Conclusions:
The results of this study confirm that NICU is a healthcare setting with a critical permeability to CA-MRSA. Active surveillance including molecular typing can help to detect and monitor the spread of antimicrobial drug-resistant organisms, and thus trigger timely control interventions.
Insights
Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) outbreaks in neonatal intensive care units (NICUs) are a concern. Active surveillance and molecular typing are crucial for detecting and controlling the spread of these resistant bacteria.
Area of Science:
- Infectious Diseases
- Neonatal Care
- Microbiology
Background:
- Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is an emerging pathogen in neonatal intensive care units (NICUs).
- NICUs are vulnerable settings for the emergence and spread of multidrug-resistant organisms.
- Understanding CA-MRSA transmission dynamics in neonates is critical for infection control.
Purpose of the Study:
- To characterize CA-MRSA isolates from a NICU outbreak.
- To examine the genetic traits and clonality of the CA-MRSA strain.
- To review neonatal case characteristics, outcomes, and transmission routes of the outbreak strain.
Main Methods:
- Active surveillance for MRSA using weekly nasal swabs in all neonates.
- Susceptibility testing and genotyping of MRSA isolates.
- Prospective data collection on clinical features and outcomes of colonized/infected infants.
Main Results:
- Fourteen infants were colonized or infected with ST1-MRSA-IVa between April and August 2011.
- The CA-MRSA strain was introduced by a transferred infant.
- Multifaceted infection control interventions successfully contained the outbreak.
Conclusions:
- NICUs are highly susceptible to CA-MRSA colonization and infection.
- Active surveillance combined with molecular typing aids in early detection and control of antimicrobial-resistant organisms.
- Timely implementation of control interventions is essential to manage outbreaks in NICUs.
Related Concept Videos
01:26Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies. Common...
01:25Clinical Significance of Antibiotic Resistance
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:29Staphylococcal Skin Infections
01:22Bacterial Meningitis I: Introduction
01:30Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care