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Updated: Nov 7, 2025
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
Published on: February 9, 2011
Risk factors for nosocomial methicillin resistant Staphylococcus aureus (MRSA) colonization in a neonatal intensive
Archana Balamohan1, Joanna Beachy2, Nina Kohn3
1Cohen Children's Medical Center of New York, New York, NY.
Aim:
To determine risk factors for MRSA colonization in a Level IV Neonatal Intensive Care Unit (NICU) independent of length of stay and gestational age in the context of a persistently circulating MRSA clone.
Design:
Retrospective matched case-control study.
Setting:
Level IV NICU PATIENTS: Infants admitted between April 4,2017- March 31,2018.
Methods:
Based on weekly surveillance cultures, infants who acquired MRSA were matched 1:1 with MRSA-negative control infants by duration of exposure (length of stay) and gestational age to determine risk factors for acquisition.
Results:
Fifty case infants were matched with controls. Isolates from 45 of the 50 cases were mupirocin-resistant and related by pulse-field gel electrophoresis. On matched univariable analysis, the following were significantly associated with a risk for MRSA acquisition: 1.Bed location in the acute area(P = 0.03), 2.Requirement of any level of respiratory support during the week prior to MRSA detection(P = 0.04), 3.Higher ATP pass rate (a measure of effectiveness of cleaning) during the week of and week prior(P = 0.01), 4.Higher MRSA colonization pressure during the week of and week prior(P< 0.0001), 5.Not having a hearing test during the time between the previous negative culture and MRSA acquisition(P = 0.01). A multivariable conditional logistic regression model (that excluded ATP pass rate) found that only colonization pressure was associated with acquisition of MRSA colonization.
Conclusions:
In an outbreak setting, MRSA colonization pressure is significantly associated with MRSA acquisition in the NICU independent of length of stay and gestational age.
Insights
In a neonatal intensive care unit (NICU), high Methicillin-resistant Staphylococcus aureus (MRSA) colonization pressure significantly increases MRSA acquisition risk in infants. This finding is independent of infant length of stay and gestational age.
Area of Science:
- Neonatal Intensive Care Unit (NICU) infections
- Infectious disease epidemiology
- Microbiology and infectious diseases
Background:
- Methicillin-resistant Staphylococcus aureus (MRSA) poses a significant threat in Neonatal Intensive Care Units (NICUs).
- Understanding specific risk factors for MRSA colonization is crucial for infection control, especially with persistent MRSA clones.
Purpose of the Study:
- To identify risk factors for MRSA colonization in a Level IV NICU.
- To determine if these risk factors are independent of infant length of stay and gestational age.
- To investigate risk factors within the context of a persistently circulating MRSA clone.
Main Methods:
- Retrospective matched case-control study design.
- Infants admitted to a Level IV NICU between April 2017 and March 2018 were included.
- MRSA-colonized infants (cases) were matched 1:1 with MRSA-negative controls based on length of stay and gestational age.
Main Results:
- Fifty case infants were matched with 50 control infants.
- Significant univariable risk factors included bed location, respiratory support, higher ATP pass rate, higher MRSA colonization pressure, and lack of hearing tests.
- Multivariable analysis revealed that only MRSA colonization pressure was significantly associated with MRSA acquisition.
Conclusions:
- MRSA colonization pressure is a significant predictor of MRSA acquisition in NICU infants during an outbreak.
- This association remains significant independent of length of stay and gestational age.
- Findings highlight the importance of monitoring and reducing MRSA colonization pressure in NICU settings.
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