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Updated: Feb 26, 2026
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
Published on: February 9, 2011
Active Surveillance Cultures and Targeted Decolonization Are Associated with Reduced Methicillin-Susceptible
Lukas Wisgrill1, Johanna Zizka, Lukas Unterasinger
1Division of Neonatology, Paediatric Intensive Care and Neuropaediatrics, Department of Paediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.
Background:
Methicillin-susceptible Staphylococcus aureus (MSSA) is a major contributor to infectious episodes of very low birth weight infants (VLBWI), resulting in significant morbidity and mortality.
Objective:
To examine the efficacy and safety of surveillance cultures and the decolonization of MSSA-colonized VLBWI.
Methods:
VLBWI admitted to our neonatal wards in 2011-2016 were retrospectively analyzed. Rates of MSSA-attributable infections were compared before and after the implementation of active surveillance cultures and the decolonization of MSSA-colonized patients. The mupirocin susceptibility of isolated MSSA strains was routinely tested.
Results:
A total of 1,056 VLBWI were included in the study, 552 in the pre-intervention period and 504 in the post-intervention period. The implementation of surveillance cultures and decolonization of colonized patients resulted in a 50% reduction of incidence rates per 1,000 patient-days of MSSA-attributable infections (1.63 [95% CI 1.12-2.31] vs. 0.83 [95% CI 0.47-1.35], p = 0.024). No adverse effects were observed from application of the decolonization protocol with mupirocin and octenidin. No mupirocin-resistant MSSA strains were detected during the study period.
Conclusion:
Implementation of an active surveillance and decolonization protocol resulted in a reduction of MSSA-attributable infections in VLBWI.
Insights
Active surveillance and decolonization significantly reduced Methicillin-susceptible Staphylococcus aureus (MSSA) infections in very low birth weight infants (VLBWI). This strategy proved safe and effective, lowering infection rates by 50% without resistance concerns.
Area of Science:
- Neonatalogy
- Infectious Diseases
- Public Health
Background:
- Methicillin-susceptible Staphylococcus aureus (MSSA) poses a significant threat to very low birth weight infants (VLBWI), causing substantial morbidity and mortality.
- Effective strategies are needed to mitigate MSSA-related infections in this vulnerable population.
Purpose of the Study:
- To evaluate the efficacy and safety of implementing surveillance cultures and decolonization protocols for MSSA-colonized VLBWI.
- To assess the impact of these interventions on MSSA-attributable infection rates.
Main Methods:
- A retrospective analysis of VLBWI admitted between 2011-2016 was conducted.
- MSSA infection rates were compared before and after the introduction of active surveillance cultures and decolonization.
- Mupirocin susceptibility of isolated MSSA strains was monitored.
Main Results:
- The study included 1,056 VLBWI (552 pre-intervention, 504 post-intervention).
- Implementation of surveillance and decolonization led to a 50% reduction in MSSA-attributable infection incidence (1.63 vs. 0.83 per 1,000 patient-days, p=0.024).
- No adverse effects were reported, and no mupirocin-resistant MSSA strains emerged.
Conclusions:
- An active surveillance and decolonization protocol effectively reduces MSSA-attributable infections in VLBWI.
- This approach is safe and does not appear to drive antimicrobial resistance.
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