Reducing Staphylococcus aureus infections in the neonatal intensive care unit

Area of Science:

• Neonatal Intensive Care Unit (NICU) Quality Improvement
• Infectious Disease Prevention
• Staphylococcus aureus (SA) Epidemiology

Background:

• Neonatal intensive care units (NICUs) are susceptible to Staphylococcus aureus (SA) infections.
• Observed increase in both methicillin-resistant SA (MRSA) and methicillin-sensitive SA (MSSA) infections in the NICU setting.
• Pre-intervention rates: MRSA at 5.1/10,000 patient days (PD) and MSSA at 3.9/10,000 PD.

Purpose of the Study:

• To decrease the incidence of SA infections to below 2.0/10,000 PD.
• To evaluate the effectiveness of a comprehensive infection prevention strategy.
• To determine the success rate of SA decolonization in neonates.

Main Methods:

• Implementation of a multi-faceted quality improvement project.
• Targeted interventions included patient factors (surveillance, cohorting, decolonization protocol), provider factors (cohorting, hand hygiene), and environmental factors (room structure, equipment).
• Focused on Staphylococcus aureus (SA) decolonization protocols for colonized patients.

Main Results:

• Significant reduction in SA infection rates post-intervention.
• MRSA infection rates decreased to 0.6/10,000 PD.
• MSSA infection rates decreased to 0.7/10,000 PD.
• Successful SA decolonization achieved in 67% of colonized neonates.

Conclusions:

• A comprehensive approach targeting patient, provider, and environmental factors effectively reduces SA infections in neonates.
• The implementation of a SA decolonization protocol was a key component in decreasing infection incidence.
• The quality improvement project successfully met its primary objective of reducing SA infection rates in the NICU.