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First outbreak with MRSA in a Danish neonatal intensive care unit: risk factors and control procedures

Benedicte Grenness Utke Ramsing1, Magnus Arpi, Erik Arthur Andersen

  • 1Department of Pediatrics, Copenhagen University Hospital Glostrup, Glostrup, Denmark. benedicte.ramsing@gmail.com

Plos One
|July 5, 2013
PubMed
Abstract

Insights

Methicillin-resistant Staphylococcus aureus (MRSA) frequently transmits in neonatal intensive care units (NICUs). Nasal continuous positive airway pressure (nCPAP) and Cesarean section were identified as key risk factors for MRSA colonization.

Area of Science:

  • Infectious Diseases
  • Neonatal Care
  • Epidemiology

Background:

  • A significant methicillin-resistant Staphylococcus aureus (MRSA) outbreak occurred in a Danish neonatal intensive care unit (NICU) between June and August 2008.
  • Understanding MRSA transmission dynamics in vulnerable neonatal populations is critical for effective infection control.

Purpose of the Study:

  • To characterize the demographic and clinical features of a large MRSA outbreak in a NICU.
  • To identify risk factors associated with MRSA transmission within the NICU setting.

Main Methods:

  • Retrospective data collection from medical records and the Danish Neobase database.
  • Typing of all MRSA isolates from neonates, family members, healthcare workers, and environmental samples.
  • Statistical analysis, including multiple logistic regression, to identify risk factors.

Main Results:

  • 32% of 99 sampled neonates were colonized with MRSA (spa-type t127, SCCmec V, PVL negative).
  • MRSA was also found in 44% of family members and 1% of healthcare workers.
  • Nasal Continuous Positive Airway Pressure (nCPAP) treatment and Cesarean section were identified as independent risk factors for MRSA acquisition.

Conclusions:

  • MRSA transmission is frequent in NICUs, particularly with unidentified colonized neonates.
  • Cesarean section and nCPAP treatment are significant risk factors for MRSA colonization in neonates.
  • Effective infection control procedures successfully managed the MRSA outbreak.

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