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Prevalence and molecular characterization of Staphylococcus aureus colonization among neonatal intensive care units

Chen-Yen Kuo1, Yi-Chuan Huang, Daniel Tsung-Ning Huang

  • 1Taiwan Pediatric Infectious Diseases Alliance, Chang Gung University, Taoyuan, Taiwan.

Neonatology
|December 21, 2013
PubMed
Abstract

Insights

Methicillin-resistant Staphylococcus aureus (MRSA) carriage was found in 4.4% of infants in Taiwan NICUs. Previous skin infections significantly predicted MRSA colonization in these vulnerable newborns.

Area of Science:

  • Neonatal intensive care unit (NICU) epidemiology
  • Infectious disease surveillance
  • Molecular epidemiology of bacterial pathogens

Background:

  • Staphylococcus aureus, including methicillin-resistant strains (MRSA), poses a significant threat in neonatal intensive care units (NICUs).
  • S. aureus colonization is a key risk factor for developing infections in neonates.

Purpose of the Study:

  • To assess the prevalence of MRSA among infants hospitalized in NICUs across Taiwan.
  • To identify risk factors associated with MRSA carriage in this population.

Main Methods:

  • A pilot, island-wide survey conducted in 2011 across 7 participating hospitals.
  • Collection of nasal and umbilical swabs from 251 NICU patients on two designated dates.
  • Analysis of S. aureus and MRSA prevalence, risk factors, antimicrobial susceptibility, and molecular characteristics of isolates.

Main Results:

  • The overall prevalence of S. aureus and MRSA carriage was 13% and 4.4%, respectively.
  • Previous skin and soft tissue infection was the sole significant predictor of MRSA carriage (OR 40.36, p = 0.011).
  • Eleven MRSA isolates revealed 3 pulsotypes, with one dominant type (73%). Most isolates harbored SCCmec type IV and belonged to sequence type 59, a known community clone in Taiwan.

Conclusions:

  • A significant proportion (4.4%) of NICU infants in Taiwan carried genetically similar community-acquired MRSA strains.
  • MRSA colonization in NICU infants is strongly associated with prior skin and soft tissue infections.

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