Evaluating a neonatal intensive care unit MRSA surveillance programme using agent-based network modelling.

Area of Science:

• Healthcare Epidemiology
• Infection Prevention and Control
• Neonatal Care

Background:

• Meticillin-resistant Staphylococcus aureus (MRSA) surveillance is standard in neonatal intensive care units (NICUs).
• The optimal frequency for MRSA monitoring in NICUs remains undetermined.
• This study addresses the need to identify effective surveillance strategies.

Purpose of the Study:

• To compare the effectiveness of various surveillance frequencies for MRSA in NICUs.
• To utilize simulation modeling to assess MRSA transmission dynamics.
• To inform optimal infection prevention strategies in high-risk neonatal settings.

Main Methods:

• Simulation modeling of 100 NICU networks (52 infants each) over six months.
• Assessed MRSA transmission under different surveillance frequencies (weekly, biweekly, triweekly, four-weekly).
• Compared fixed frequencies with dynamic surveillance (NICU policy) and evaluated decolonization/isolation interventions.

Main Results:

• Increased surveillance frequency correlated with decreased MRSA colonization (2.9 infants/episode with four-weekly vs. 0.6 with weekly).
• Mean colonization duration reduced significantly with more frequent monitoring (307 hours to 61 hours).
• Higher surveillance frequency inversely impacted isolation room availability (61% success rate for four-weekly vs. 49% for weekly).

Conclusions:

• Effective MRSA surveillance necessitates balancing early detection with resource constraints.
• Frequent monitoring reduces MRSA colonization but increases demand for isolation facilities.
• The dynamic surveillance policy demonstrated performance comparable to biweekly monitoring.