Epidemiology and risk factors for recurrent Staphylococcus aureus colonization following active surveillance and decolonization in the NICU
| Autor: | Aaron M. Milstone, Karen C. Carroll, Annie Voskertchian, Joshua Betz, Gezahegn Gorfu, Ibukunoluwa C. Akinboyo, Tracy L. Ross |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Microbiology (medical) Staphylococcus aureus medicine.medical_specialty Neonatal intensive care unit Epidemiology Mupirocin 030501 epidemiology medicine.disease_cause Article 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Risk Factors Intensive Care Units Neonatal Internal medicine Odds Ratio medicine Humans Colonization 030212 general & internal medicine Administration Intranasal Retrospective Studies Cross Infection business.industry Infant Newborn Infant Retrospective cohort study Odds ratio Staphylococcal Infections Anti-Bacterial Agents Disinfection Infectious Diseases chemistry Baltimore Carrier State Female 0305 other medical science business Nasal cannula |
| Zdroj: | Infection Control & Hospital Epidemiology. 39:1334-1339 |
| ISSN: | 1559-6834 0899-823X |
| Popis: | ObjectivesTo examine neonatal risk factors associated with recurrent Staphylococcus aureus colonization and to determine the genetic relatedness of S. aureus strains cultured from neonates before and after decolonization.Study designSingle-center retrospective cohort study of neonates admitted to the neonatal intensive care unit (NICU) from April 2013 to December 2015, during which weekly nasal cultures from hospitalized NICU patients were routinely obtained for S. aureus surveillance.SettingJohns Hopkins Hospital’s 45-bed level IV NICU in Baltimore, Maryland.MethodsDemographics and clinical data were collected on all neonates admitted to the NICU with S. aureus nasal colonization who underwent mupirocin-based decolonization during the study period. A decolonized neonate was defined as a neonate with ≥1 negative culture after intranasal mupirocin treatment. Pulsed-field gel electrophoresis was used for strain typing.ResultsOf 2,060 infants screened for S. aureus, 271 (13%) were colonized, and 203 of these 271 (75%) received intranasal mupirocin. Of those treated, 162 (80%) had follow-up surveillance cultures, and 63 of these 162 infants (39%) developed recurrent colonization after treatment. The S. aureus strains were often genetically similar before and after decolonization. The presence of an endotracheal tube or nasal cannula/mask was associated with an increased risk of recurrent S. aureus colonization (hazard ratio [HR], 2.65; 95% confidence interval [CI], 1.19–5.90; and HR, 2.21; 95% CI, 1.02–4.75, respectively).ConclusionStrains identified before and after decolonization were often genetically similar, and the presence of invasive respiratory devices increased the risk of recurrent S. aureus nasal colonization in neonates. To improve decolonization efficacy, alternative strategies may be needed. |
| Databáze: | OpenAIRE |
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