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Updated: Dec 26, 2025
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
Published on: February 9, 2011
Risk factors and intraoral breast milk application for methicillin-resistant Staphylococcus aureus colonization in
Mikihiro Inoue1, Keiichi Uchida1, Yuka Nagano1
1Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Tsu, Japan.
Background:
Our previous study identified methicillin-resistant Staphylococcus aureus (MRSA) colonization as an independent risk factor for neonatal surgical site infection. Here we introduce intraoral breast milk application (IBMA) during a fasting state to prevent MRSA colonization. We aimed to evaluate both the risk factors for MRSA colonization and the efficacy of IBMA in neonatal surgical patients.
Methods:
A retrospective review was performed using admission data from 2007 to 2016. Neonatal patients who underwent surgery and were tested periodically for MRSA colonization were evaluated for an association between MRSA colonization and perinatal or perioperative factors.
Results:
The overall incidence of MRSA colonization for the 159 patients enrolled in this study was 16.4%. Univariate analysis showed that MRSA colonization was significantly more frequent in the following patients: those with Down syndrome, those admitted on their day of birth, those in need of fasting immediately after birth, and those not receiving IBMA. Multivariate analysis showed that comorbid Down syndrome was an independent risk factor (hazard ratio: 4.6; 95% confidence interval: 1.2-19.5, P = 0.03) and implementation of IBMA was an independent preventive factor for MRSA colonization (hazard ratio: 0.4; 95% confidence interval: 0.1-0.9, P = 0.04). MRSA-positive patients admitted significantly earlier and stayed longer preoperatively than MRSA-negative patients.
Conclusions:
In neonates undergoing surgery, and patients with Down syndrome, early diagnosis after birth and a long waiting period before operation may be associated with MRSA colonization. Intraoral breast milk application may be beneficial for preventing MRSA colonization.
Insights
Intraoral breast milk application (IBMA) can prevent methicillin-resistant Staphylococcus aureus (MRSA) colonization in neonatal surgical patients. Patients with Down syndrome face higher MRSA risks, highlighting the need for targeted interventions.
Area of Science:
- Neonatal surgery
- Infectious disease prevention
- Microbiology
Background:
- Methicillin-resistant Staphylococcus aureus (MRSA) colonization is a risk factor for neonatal surgical site infections.
- Intraoral breast milk application (IBMA) is a novel strategy to prevent MRSA colonization.
- Previous studies identified MRSA colonization as a significant risk factor in neonates.
Purpose of the Study:
- To identify risk factors for MRSA colonization in neonatal surgical patients.
- To evaluate the efficacy of IBMA in preventing MRSA colonization.
- To analyze associations between perinatal/perioperative factors and MRSA colonization.
Main Methods:
- Retrospective review of 159 neonatal surgical patients' admission data (2007-2016).
- Periodic MRSA colonization testing.
- Analysis of perinatal and perioperative factors influencing MRSA colonization.
Main Results:
- Overall MRSA colonization incidence was 16.4%.
- Independent risk factors for MRSA colonization included Down syndrome (HR: 4.6) and delayed IBMA (HR: 0.4).
- Patients with Down syndrome, early admission, and fasting post-birth showed higher MRSA rates.
Conclusions:
- Down syndrome is an independent risk factor for MRSA colonization in neonates undergoing surgery.
- IBMA demonstrates significant preventive effects against MRSA colonization.
- Early diagnosis and prolonged pre-operative waiting may correlate with MRSA colonization.
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