Methicillin-resistant Staphylococcus aureus nasal colonization in a level III neonatal intensive care unit: Incidence and risk factors

Giovanni Corsello, Daniela Maria Geraci, Caterina Mammina, Laura Saporito, Mario Giuffre, Emanuele Amodio, Celestino Bonura, Giovanni Corsello, Caterina Mammina, Celestino Bonura, Mario Giuffrè, Rita Ortolano

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Abstract

Objective: To describe epidemiologic features and identify risk factors for methicillin-resistant Staphylococcus aureus (MRSA) acquisition in a level III neonatal intensive care unit (NICU). Setting: A prospective, cohort study in a university-affiliated NICU with an infection control program including weekly nasal cultures of all neonates. Methods: Demographic, clinical, and microbiologic data were prospectively collected between June 2009 and June 2013. Molecular characterization of MRSA isolates was done by multilocus variable number tandem repeat fingerprinting, staphylococcal cassette chromosome mec typing, and on representative isolates by multilocus sequence typing and s. pa typing. Results: Of 949 neonates, 217 (22.87%) had a culture growing MRSA, including 117 neonates testing positive at their first sampling. Of these latter infants, 96 (82.05%) were born with the infection and 59 (50.43%) had been transferred from the nursery. Length of stay and colonization pressure were strong independent predictors of MRSA acquisition. Among MRSA isolates, 7 sequence types were identified, with ST22-IVa, spa type t223, being the predominant strain. Conclusions: In an endemic area, early MRSA acquisition and high colonization pressure, likely related to an influx of colonized infants from a well-infant nursery, can support persistence of MRSA in NICUs. Surveillance, molecular tracking of strains, and reinforcement of infection control practices, involving well-infant nurseries in a comprehensive infection control program, could be helpful in containing MRSA transmission.
Lingua originaleEnglish
pagine (da-a)476-481
Numero di pagine6
RivistaAmerican Journal of Infection Control
Volume43
Stato di pubblicazionePublished - 2015

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Neonatal Intensive Care Units
Methicillin-Resistant Staphylococcus aureus
Nose
Incidence
Nurseries
Infection Control
Newborn Infant
Multilocus Sequence Typing
Pressure
Minisatellite Repeats
Length of Stay
Cohort Studies
Chromosomes
Demography
Prospective Studies
Infection

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Health Policy
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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title = "Methicillin-resistant Staphylococcus aureus nasal colonization in a level III neonatal intensive care unit: Incidence and risk factors",
abstract = "Objective: To describe epidemiologic features and identify risk factors for methicillin-resistant Staphylococcus aureus (MRSA) acquisition in a level III neonatal intensive care unit (NICU). Setting: A prospective, cohort study in a university-affiliated NICU with an infection control program including weekly nasal cultures of all neonates. Methods: Demographic, clinical, and microbiologic data were prospectively collected between June 2009 and June 2013. Molecular characterization of MRSA isolates was done by multilocus variable number tandem repeat fingerprinting, staphylococcal cassette chromosome mec typing, and on representative isolates by multilocus sequence typing and s. pa typing. Results: Of 949 neonates, 217 (22.87{\%}) had a culture growing MRSA, including 117 neonates testing positive at their first sampling. Of these latter infants, 96 (82.05{\%}) were born with the infection and 59 (50.43{\%}) had been transferred from the nursery. Length of stay and colonization pressure were strong independent predictors of MRSA acquisition. Among MRSA isolates, 7 sequence types were identified, with ST22-IVa, spa type t223, being the predominant strain. Conclusions: In an endemic area, early MRSA acquisition and high colonization pressure, likely related to an influx of colonized infants from a well-infant nursery, can support persistence of MRSA in NICUs. Surveillance, molecular tracking of strains, and reinforcement of infection control practices, involving well-infant nurseries in a comprehensive infection control program, could be helpful in containing MRSA transmission.",
keywords = "Active surveillance; Colonization pressure; Infection control; Infectious Diseases; Public Health, Environmental and Occupational Health; Epidemiology; Health Policy",
author = "Giovanni Corsello and Geraci, {Daniela Maria} and Caterina Mammina and Laura Saporito and Mario Giuffre and Emanuele Amodio and Celestino Bonura and Giovanni Corsello and Caterina Mammina and Celestino Bonura and Mario Giuffr{\`e} and Rita Ortolano",
year = "2015",
language = "English",
volume = "43",
pages = "476--481",
journal = "American Journal of Infection Control",
issn = "0196-6553",
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TY - JOUR

T1 - Methicillin-resistant Staphylococcus aureus nasal colonization in a level III neonatal intensive care unit: Incidence and risk factors

AU - Corsello, Giovanni

AU - Geraci, Daniela Maria

AU - Mammina, Caterina

AU - Saporito, Laura

AU - Giuffre, Mario

AU - Amodio, Emanuele

AU - Bonura, Celestino

AU - Corsello, Giovanni

AU - Mammina, Caterina

AU - Bonura, Celestino

AU - Giuffrè, Mario

AU - Ortolano, Rita

PY - 2015

Y1 - 2015

N2 - Objective: To describe epidemiologic features and identify risk factors for methicillin-resistant Staphylococcus aureus (MRSA) acquisition in a level III neonatal intensive care unit (NICU). Setting: A prospective, cohort study in a university-affiliated NICU with an infection control program including weekly nasal cultures of all neonates. Methods: Demographic, clinical, and microbiologic data were prospectively collected between June 2009 and June 2013. Molecular characterization of MRSA isolates was done by multilocus variable number tandem repeat fingerprinting, staphylococcal cassette chromosome mec typing, and on representative isolates by multilocus sequence typing and s. pa typing. Results: Of 949 neonates, 217 (22.87%) had a culture growing MRSA, including 117 neonates testing positive at their first sampling. Of these latter infants, 96 (82.05%) were born with the infection and 59 (50.43%) had been transferred from the nursery. Length of stay and colonization pressure were strong independent predictors of MRSA acquisition. Among MRSA isolates, 7 sequence types were identified, with ST22-IVa, spa type t223, being the predominant strain. Conclusions: In an endemic area, early MRSA acquisition and high colonization pressure, likely related to an influx of colonized infants from a well-infant nursery, can support persistence of MRSA in NICUs. Surveillance, molecular tracking of strains, and reinforcement of infection control practices, involving well-infant nurseries in a comprehensive infection control program, could be helpful in containing MRSA transmission.

AB - Objective: To describe epidemiologic features and identify risk factors for methicillin-resistant Staphylococcus aureus (MRSA) acquisition in a level III neonatal intensive care unit (NICU). Setting: A prospective, cohort study in a university-affiliated NICU with an infection control program including weekly nasal cultures of all neonates. Methods: Demographic, clinical, and microbiologic data were prospectively collected between June 2009 and June 2013. Molecular characterization of MRSA isolates was done by multilocus variable number tandem repeat fingerprinting, staphylococcal cassette chromosome mec typing, and on representative isolates by multilocus sequence typing and s. pa typing. Results: Of 949 neonates, 217 (22.87%) had a culture growing MRSA, including 117 neonates testing positive at their first sampling. Of these latter infants, 96 (82.05%) were born with the infection and 59 (50.43%) had been transferred from the nursery. Length of stay and colonization pressure were strong independent predictors of MRSA acquisition. Among MRSA isolates, 7 sequence types were identified, with ST22-IVa, spa type t223, being the predominant strain. Conclusions: In an endemic area, early MRSA acquisition and high colonization pressure, likely related to an influx of colonized infants from a well-infant nursery, can support persistence of MRSA in NICUs. Surveillance, molecular tracking of strains, and reinforcement of infection control practices, involving well-infant nurseries in a comprehensive infection control program, could be helpful in containing MRSA transmission.

KW - Active surveillance; Colonization pressure; Infection control; Infectious Diseases; Public Health

KW - Environmental and Occupational Health; Epidemiology; Health Policy

UR - http://hdl.handle.net/10447/125232

UR - http://www.journals.elsevier.com/ajic-american-journal-of-infection-control/

M3 - Article

VL - 43

SP - 476

EP - 481

JO - American Journal of Infection Control

JF - American Journal of Infection Control

SN - 0196-6553

ER -