Clinical and Economic Impact of Methicillin-Resistant Staphylococcus aureus Colonization or Infection on Neonates in Intensive Care Units

2010 ◽  
Vol 31 (2) ◽  
pp. 177-182 ◽  
Author(s):  
Xiaoyan Song ◽  
Eli Perencevich ◽  
Joseph Campos ◽  
Billie L. Short ◽  
Nalini Singh
Keyword(s):  
Staphylococcus Aureus ◽  
Cohort Study ◽  
Intensive Care ◽  
Length Of Stay ◽  
Economic Impact ◽  
Mortality Risk ◽  
Hospital Charges ◽  
Methicillin Resistant ◽  
Control Subjects ◽  
Mrsa Colonization

Objective.The rising incidence and mortality of methicillin-resistant Staphylococcus aureus (MRSA) colonization or infection in children has become a great concern. This study aimed to determine the clinical and economic impact of MRSA colonization or infection on infants and to measure excess mortality, length of stay, and hospital charges attributable to MRSA.Design.This is a retrospective cohort study.Setting and Patients.The study included infants admitted to a level III-IV neonatal intensive care unit from September 1, 2004, through March 31, 2008.Methods.A time-dependent proportional hazard model was used to analyze the association between MRSA colonization or infection and mortality. The relationships between MRSA colonization or infection and length of stay and between MRSA colonization or infection and hospital charges were assessed using a matched cohort study design.Results.Of 2,280 infants, 191 (8.4%) had MRSA colonization or infection. Of 132 MRSA isolates with antibiotic susceptibility results, 106 were resistant to clindamycin and/or trimethoprim-sulfamethoxazole, thus representing a noncommunity phenotype. The mortality rate was 17.8% for patients with MRSA colonization or infection and 11.5% for control subjects. Neither MRSA colonization (hazard ratio [HR], 0.9 [95% confidence interval {CI}, 0.5-1.5]; P > .05) nor infection (HR, 1.2 [95% CI, 0.7-1.9]; P > .05) was associated with increased mortality risk. Infection caused by MRSA strains that were resistant to clindamycin and/or trimethoprim-sulfamethoxazole increased the mortality risk by 40% (HR, 1.4 [95% CI, 0.9-2.2]; P > .05), compared with the mortality risk of control subjects, but the increase was not statistically significant. MRSA infection independently increased length of stay by 40 days (95% CI, 34.2—45.6; P < .001) and was associated with an extra charge of $164,301 (95% CI, $158,712-$169,889; P < .001).Conclusions.MRSA colonization or infection in infants is associated with significant morbidity and financial burden but is not independently associated with increased mortality.

scholarly journals Prevalence of methicillin‐resistant Staphylococcus aureus among health care workers of intensive care units in Ecuador

2014 ◽  
Vol 8 (01) ◽  
pp. 116-119 ◽  
Author(s):  
Alejandra Ruiz ◽  
Marcelo Mora ◽  
Camilo Zurita ◽  
Danny Larco ◽  
Yadira Toapanta ◽  
...  
Keyword(s):  
Health Care ◽  
Staphylococcus Aureus ◽  
Intensive Care ◽  
Health Care Workers ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Health Care Facilities ◽  
Methicillin Resistant ◽  
Care Workers ◽  
Care Facilities ◽  
Mrsa Colonization

Introduction: Colonization of health care workers with methicillin-resistant Staphylococcus aureus (MRSA) has been an important route of dispersion and infection of MRSA and has been implicated in epidemic outbreaks. The objective of the present study was to assess prevalence of MRSA colonization in the anterior nares of health care personnel at the intensive care unit (ICUs) of three hospital facilities in Quito, Ecuador. Methodology: The prevalence of MRSA in specimens from all ICU health care workers of three hospitals was measured by using a real-time PCR assay and CHROMagar MRSA. Results: The prevalence of MRSA among the three health care facilities was 2.4%. Conclusion: The prevalence of MRSA colonization was relatively low compared to other studies and showed no differences between hospital facilities.

Outbreak of Methicillin-Resistant Staphylococcus aureus Colonization and Infection in a Neonatal Intensive Care Unit Epidemiologically Linked to a Healthcare Worker With Chronic Otitis

2006 ◽  
Vol 27 (6) ◽  
pp. 581-585 ◽  
Author(s):  
Mary L. Bertin ◽  
Joan Vinski ◽  
Steven Schmitt ◽  
Camille Sabella ◽  
Lara Danziger-Isakov ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Staphylococcus Aureus ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Molecular Typing ◽  
Neonatal Intensive Care ◽  
Outbreak Strain ◽  
Methicillin Resistant ◽  
Surveillance Cultures ◽  
Mrsa Colonization

Objective.To describe the investigation and interventions necessary to contain an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) colonization and infection in a neonatal intensive care unit (NICU).Design.Retrospective case finding that involved prospective performance of surveillance cultures for detection of MRSA and molecular typing of MRSA by repetitive-sequence polymerase chain reaction (rep-PCR).Setting.Level III NICU in a tertiary care center.Participants.Three neonates in a NICU were identified with MRSA bloodstream infection on April 16, 2004. A point prevalence survey identified 6 additional colonized neonates (attack rate, 75% [9 of 12 neonates]). The outbreak strain was phenotypically unusual.Interventions.Cohorting and mupirocin therapy were initiated for neonates who had acquired MRSA during the outbreak. Contact precautions were introduced in the NICU, and healthcare workers (HCWs) were retrained in cleaning and disinfection procedures and hand hygiene. Noncolonized neonates and newly admitted patients had surveillance cultures performed 3 times per week.Results.Two new colonized neonates were identified 1 month later. HCW X, who had worked in the NICU since June 2003, was identified as having chronic otitis. MRSA was isolated from cultures of swab specimens from HCW X's ear canal and nares. HCW X was epidemiologically linked to the outbreak. Molecular typing (by rep-PCR) confirmed that the isolates from HCW X and from the neonates were more than 90% similar. Retrospective review of NICU isolates revealed that the outbreak strain was initially cultured from a neonate 2 months after HCW X began working on the unit. The epidemic strain was eradicated after removing HCW X from patient care in the NICU.Conclusion.An outbreak of MRSA colonization and infection in a NICU was epidemiologically linked to a HCW with chronic otitis externa and nasal colonization with MRSA. Eradication was not achieved until removal of HCW X from the NICU. Routine surveillance for MRSA may have allowed earlier recognition of the outbreak and is now standard practice in our NICU.

scholarly journals Risk Factors for Persistent Methicillin-Resistant Staphylococcus aureus Colonization in Children with Multiple Intensive Care Unit Admissions

2013 ◽  
Vol 34 (7) ◽  
pp. 748-750 ◽  
Author(s):  
Victor O. Popoola ◽  
Pranita Tamma ◽  
Nicholas G. Reich ◽  
Trish M. Perl ◽  
Aaron M. Milstone
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Staphylococcus Aureus ◽  
Intensive Care ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Methicillin Resistant ◽  
Contact Precautions ◽  
Mrsa Colonization

We studied methicillin-resistant Staphylococcus aureus (MRSA)-colonized children with multiple intensive care unit (ICU) admissions to assess the persistence of MRSA colonization. Our data found that children with more than 1 year between ICU admissions had a higher prevalence of MRSA colonization than the overall ICU population, which supports empirical contact precautions for children with previous MRSA colonization.

Universal Admission Screening for Methicillin-Resistant Staphylococcus aureus in a Level HID Neonatal Intensive Care Unit: The First 9 Months

2011 ◽  
Vol 32 (4) ◽  
pp. 398-400 ◽  
Author(s):  
Patrick J. Myers ◽  
John Marcinak ◽  
Michael Z. David ◽  
Diana L. Zychowski ◽  
Susan Boyle-Vavra ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Staphylococcus Aureus ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Methicillin Resistant ◽  
Admission Screening ◽  
Polymerase Chain ◽  
Mrsa Colonization ◽  
Illinois General Assembly

In response to epidemic methicillin-resistant Staphylococcus aureus (MRSA) in the community, the Illinois General Assembly mandated that all patients admitted to intensive care units statewide be screened for MRSA. Screening was instituted at our neonatal intensive care unit (NICU) in September 2007 by a polymerase chain reaction (PCR)-based strategy. The law created an opportunity to determine the rate of MRSA colonization among neonates, to gather information about subsequent MRSA infections, and to evaluate risk factors for MRSA colonization on admission to the NICU.

Methicillin-Resistant Staphylococcus aureus and Other Multidrug-Resistant Colonizations/Infections in an Intensive Care Unit: Predictive Factors

2018 ◽  
Vol 21 (2) ◽  
pp. 190-197
Author(s):  
Elena Ochotorena ◽  
Juan José Hernández Morante ◽  
Rubén Cañavate ◽  
Roberto Andrés Villegas ◽  
Inmaculada Viedma
Keyword(s):  
Intensive Care Unit ◽  
Staphylococcus Aureus ◽  
Intensive Care ◽  
Hospital Stay ◽  
Nosocomial Infections ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Multidrug Resistant ◽  
Apache Ii Score ◽  
Methicillin Resistant ◽  
Mrsa Colonization

Introduction and Objectives: Methicillin-resistant Staphylococcus aureus (MRSA) is the most prevalent pathogen causing nosocomial infections in hospitals and health centers. This work is an effort to understand the epidemiology of MRSA and other multidrug-resistant pathogens in an intensive care unit (ICU) and to analyze characteristics that might determine the risk of MRSA colonization/infection in this unit. Method: An observational, 1-year prospective longitudinal study was conducted to obtain information about MRSA and other multidrug-resistant colonizations/infections. The study was conducted with ICU patients with an artificial airway. Data were obtained from the National Study of the Control of Nosocomial Infections in Intensive Care Units database. Results: MRSA colonization was highly prevalent (33%); however, other pathogens like gram(−) Bacillus showed a higher infectious potency. Acute Physiology and Chronic Health Evaluation (APACHE-II) score >15 and hospital stay of >4 days were the main variables that significantly predicted the risk of developing MRSA colonization ( p < .001 in both cases). Moreover, the presence of MRSA increased the risk of developing a second multidrug-resistant colonization/infection, especially with methicillin-resistant Pseudomona. Discussion: The high prevalence of MRSA emphasizes the need to continue studying risk factors for MRSA colonization/infection, which may allow early identification of this pathogen. Therefore, we propose the use of the APACHE-II score and length of hospital stay to predict increased risk of MRSA colonization. Awareness of the heightened risk in particular patients could lead to early detection and prevention.

scholarly journals Identification and Eradication of Methicillin-Resistant Staphylococcus aureus Colonization in the Neonatal Intensive Care Unit: Results of a National Survey

2010 ◽  
Vol 31 (7) ◽  
pp. 766-768 ◽  
Author(s):  
Aaron M. Milstone ◽  
Xiaoyan Song ◽  
Susan Coffin ◽  
Alexis Elward ◽  
Keyword(s):  
Intensive Care Unit ◽  
Staphylococcus Aureus ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Current Practice ◽  
Methicillin Resistant ◽  
Nicu Admission ◽  
Healthcare Epidemiology ◽  
Mrsa Colonization

We surveyed members of the Society for Healthcare Epidemiology of America to assess current practice with regard to identifying and eradicating methicillin-resistant Staphylococcus aureus (MRSA) colonization in the neonatal intensive care unit (NICU). Although most respondents (86%) screened patients for MRSA colonization, variation existed in the number of anatomic sites sampled and in the use of culture at NICU admission, empirical institution of isolation precautions, and MRSA decolonization therapy. Evidence-based prevention strategies for MRSA transmission and infection are needed.

scholarly journals Vertical transmission of methicillin-resistant Staphylococcus aureus at delivery and its clinical impact: an observational, prospective cohort study

2021 ◽  
Author(s):  
Jumpei Ogura ◽  
Yoshihide Inayama ◽  
Naoko Sasamoto ◽  
Takahiro Hirayama ◽  
Tsutomu Ohara ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Cohort Study ◽  
Pregnant Women ◽  
Vertical Transmission ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Transmission Rate ◽  
Adverse Outcomes ◽  
Methicillin Resistant ◽  
Vertical Transmission Rate ◽  
Mrsa Colonization

Objectives: To accurately assess the vertical transmission rate of Methicillin-resistant Staphylococcus aureus (MRSA) and its clinical impacts on pregnant mothers and neonates. Design: A prospective observational cohort study. Setting: Japan. Population: 898 pregnant women and their 905 neonates delivered in gestation week > 32+0 at Toyooka Hospital from August 2016 to December 2017. Methods: MRSA was cultured from the nasal and vaginal samples taken from mothers at enrollment and the nasal and umbilical samples taken from neonates immediately after their birth. We examined the vertical transmission rate of MRSA in mother-neonate pairs. We used multivariable logistic regression to identify maternal/neonatal adverse outcomes associated with maternal MRSA colonization. Main outcome measures: The frequency of maternal/neonatal MRSA colonization and adverse outcomes. Results: The prevalence of maternal MRSA colonization was 6.1% (55/898), and that of neonates was 0.8% (8/905). The prevalence of neonatal MRSA was 12.7% (7/55 mother-neonate pairs) in the MRSA-positive mothers, whereas it was only 0.12% (1/843 pairs) in the MRSA-negative mothers (OR: 121, 95% CI: 14.6-1000). When the maternal vaginal-MRSA was positive, the vertical transmission rate was 44.4% (4/9). Skin and soft tissue infections (SSTIs) developed significantly more frequently in neonates born to the MRSA-positive mothers (OR: 7.47, 95% CI: 2.50-22.3). Conclusions: The prevalence of MRSA in pregnant women was approximately 6%. The vertical transmission rate of vaginal MRSA was as high as 44.4%. Maternal MRSA colonization is associated with increased development of neonatal SSTIs via vertical transmission.

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