Related Experiment Video
Updated: May 2, 2026
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
Published on: February 9, 2011
MRSA colonization and risk of infection in the neonatal and pediatric ICU: a meta-analysis
Fainareti N Zervou1, Ioannis M Zacharioudakis, Panayiotis D Ziakas
1Infectious Diseases Division, Rhode Island Hospital, Providence, Rhode Island; and Warren Alpert Medical School of Brown University, Providence, Rhode Island.
Background And Objective:
Methicillin-resistant Staphylococcus aureus (MRSA) is a significant cause of morbidity and mortality in NICUs and PICUs. Our objective was to assess the burden of MRSA colonization on admission, study the time trends, and examine the significance of MRSA colonization in this population.
Methods:
PubMed and Embase databases were consulted. Studies that reported prevalence of MRSA colonization on ICU admission were selected. Two authors independently extracted data on MRSA colonization and infection.
Results:
We identified 18 suitable articles and found an overall prevalence of MRSA colonization of 1.9% (95% confidence interval [CI] 1.3%-2.6%) on admission to the NICU or PICU, with a stable trend over the past 12 years. Interestingly, 5.8% (95% CI 1.9%-11.4%) of outborn neonates were colonized with MRSA on admission to NICU, compared with just 0.2% (95% CI 0.0%-0.9%) of inborn neonates (P = .01). The pooled acquisition rate of MRSA colonization was 4.1% (95% CI 1.2%-8.6%) during the NICU and PICU stay and was as high as 6.1% (95% CI 2.8%-10.6%) when the NICU population was studied alone. There was a relative risk of 24.2 (95% CI 8.9-66.0) for colonized patients to develop a MRSA infection during hospitalization.
Conclusions:
In the NICU and PICU, there are carriers of MRSA on admission, and MRSA colonization in the NICU is almost exclusively associated with outborn neonates. Importantly, despite infection control measures, the acquisition rate is high, and patients colonized with MRSA on admission are more likely to suffer a MRSA infection during hospitalization.
Insights
Methicillin-resistant Staphylococcus aureus (MRSA) colonization is present on admission to NICUs and PICUs. Colonized patients face a significantly higher risk of developing MRSA infections during their hospital stay.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Neonatal and Pediatric Health
Background:
- Methicillin-resistant Staphylococcus aureus (MRSA) poses a significant threat, causing morbidity and mortality in Neonatal Intensive Care Units (NICUs) and Pediatric Intensive Care Units (PICUs).
- Understanding MRSA colonization burden and trends is crucial for effective infection control strategies.
Purpose of the Study:
- To assess the prevalence of MRSA colonization upon admission to NICUs and PICUs.
- To analyze temporal trends in MRSA colonization.
- To determine the clinical significance of MRSA colonization in these vulnerable patient populations.
Main Methods:
- A systematic literature review was conducted using PubMed and Embase databases.
- Studies reporting MRSA colonization prevalence on ICU admission were selected.
- Data on MRSA colonization and infection were independently extracted by two authors.
Main Results:
- Overall MRSA colonization prevalence on admission was 1.9% (95% CI 1.3%-2.6%), showing a stable trend over 12 years.
- Outborn neonates had a significantly higher colonization rate (5.8%) compared to inborn neonates (0.2%) (P = .01).
- Acquisition rates during NICU/PICU stays were 4.1% overall and 6.1% for NICU alone. Colonized patients had a 24.2-fold increased risk of developing MRSA infection.
Conclusions:
- MRSA carriers are present on admission to NICUs and PICUs.
- MRSA colonization in NICUs is predominantly linked to outborn neonates.
- High acquisition rates and increased infection risk highlight the importance of MRSA colonization surveillance and control.
Related Concept Videos
01:25Clinical Significance of Antibiotic Resistance
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:25Mechanism of Antibiotic Resistance in MRSA
01:26Bacterial Meningitis II: Pathophysiology
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.