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Updated: Aug 31, 2025
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
Published on: February 9, 2011
Molecular epidemiology of meticillin-susceptible Staphylococcus aureus in the neonatal intensive care unit
Y Toyama1, K Hisata2, Y Kasai3
1Department of Pediatrics and Adolescent Medicine, Graduate School of Medicine, Juntendo University, Tokyo, Japan.
Background:
Staphylococcus aureus - both meticillin-resistant S. aureus (MRSA) and meticillin-susceptible S. aureus (MSSA) - is a major cause of neonatal infections. Infection control measures have not lowered the incidence of MSSA infections to the same degree as that of MRSA infections.
Aim:
To investigate the transmission pathway of MSSA in neonatal intensive care unit (NICU) using genetic analysis.
Methods:
Neonatal patients, their parents, and healthcare workers were swab-tested in the NICU at our hospital at the time of hospitalization and then every month thereafter from October 1st, 2018 to March 31st, 2019. Whole-genome sequencing was performed to test for MSSA strains. Multi-locus sequence typing and single nucleotide polymorphism analysis were used to identify strains and understand their relatedness.
Findings:
There were 16 MSSA-positive patients. Four MSSA-positive patients shared strains from the same phylogenetic groups as those of healthcare workers. One presented the same strain as the parent. MSSA-positive twin neonates shared the same strain. Ten had sporadic strains; 32 of the 97 tested healthcare workers were MSSA positive.
Conclusion:
The findings of this study suggest that the route of transmission of MSSA in NICU may be through MSSA in the hospital environment in addition to horizontal transmission via healthcare workers. Along with hand hygiene with alcohol, thorough environmental maintenance and parental education are important for infection control in NICUs targeting MSSA.
Insights
Meticillin-susceptible Staphylococcus aureus (MSSA) spreads in neonatal intensive care units (NICUs) via healthcare workers and the hospital environment. Enhanced infection control, including environmental cleaning and parental education, is crucial for MSSA prevention.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Genomics
Background:
- Staphylococcus aureus, including meticillin-resistant (MRSA) and meticillin-susceptible (MSSA) strains, is a significant cause of neonatal infections.
- Current infection control measures have been less effective in reducing MSSA incidence compared to MRSA.
Purpose of the Study:
- To elucidate the transmission pathways of MSSA within a neonatal intensive care unit (NICU) setting.
- Utilize advanced genetic analysis to trace MSSA transmission routes.
Main Methods:
- Swab testing of neonatal patients, parents, and healthcare workers in the NICU over a six-month period.
- Whole-genome sequencing, multi-locus sequence typing, and single nucleotide polymorphism analysis to identify and compare MSSA strains.
Main Results:
- 16 neonates tested positive for MSSA.
- MSSA strains from four patients were linked to strains found in healthcare workers, and one patient shared a strain with a parent.
- MSSA-positive twins harbored identical strains, while 10 patients had sporadic strains. 32 out of 97 healthcare workers were MSSA positive.
Conclusions:
- MSSA transmission in NICUs likely occurs through both horizontal transmission by healthcare workers and the hospital environment.
- Effective MSSA infection control requires stringent hand hygiene, meticulous environmental maintenance, and comprehensive parental education.
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