Prevalence of and risk factors for methicillin-resistant Staphylococcus aureus colonization and infection among infants at a level III neonatal intensive care unit
Prevalence of and risk factors for methicillin-resistant Staphylococcus aureus colonization and infection among infants at a level III neonatal intensive care unit
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DOI：
10.1016/j.ajic.2010.07.013
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发表时间：
2011-02-01
影响因子：
4.9
通讯作者：
Rathore, Mobeen H.
中科院分区：
文献类型：
--
作者：
Maraqa, Nizar F.;Aigbivbalu, Lemuel;Rathore, Mobeen H.
背景：耐甲氧西林金黄色葡萄球菌 (MRSA) 是新生儿重症监护病房 (NICU) 患者的一种众所周知的院内病原体，可导致早产儿严重感染和 NICU 中 MRSA 长期爆发。 目的：我们的目标是确定 NICU 中 MRSA 定植和感染的患病率并确定风险因素，以及对 NICU 中 MRSA 进行主动监测计划的影响。方法：我们每周收集鼻部 MRSA 监测数据对 3 年来入住 NICU 的 2,048 名婴儿进行了培养。回顾性收集这些婴儿的数据。对定植婴儿和感染婴儿的MRSA特征进行分析和比较。结果：6.74%的婴儿检出MRSA定植，22%的定植婴儿发生MRSA感染。仅使用临床培养，149 名 MRSA 感染婴儿中仅鉴定出 41 名 (27.5%)。大多数 (75%) 在定植后 17 天内出现 MRSA 感染。 NICU 住院时间每增加 10 天，感染和定植 MRSA 的几率分别增加 1.32 和 1.29。定植与 NICU 住院时间延长、低出生体重、低胎龄和多胎妊娠状态显着相关。结论：定植是 NICU 感染 MRSA 的危险因素。临床文化低估了 NICU 中受 MRSA 影响的婴儿，而主动监测文化可以更早地发现受 MRSA 影响的婴儿并限制院内传播。
Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a well-known nosocomial pathogen of neonatal intensive care unit (NICU) patients and can cause both serious infections in preterm neonates and prolonged MRSA outbreaks in NICUs.Objectives: Our objectives were to determine the prevalence of and identify risk factors for MRSA colonization and infection in the NICU and the impact of an active surveillance program on MRSA in the NICU.Methods: We collected weekly nasal MRSA surveillance cultures on 2,048 infants admitted to NICU over 3 years. Data on these infants were collected retrospectively. Characteristics of MRSA colonized and infected infants were analyzed and compared.Results: MRSA colonization was detected in 6.74% of infants, and MRSA infection occurred in 22% of those colonized. Using clinical cultures alone, only 41 (27.5%) of 149 MRSA affected infants were identified. The majority (75%) developed MRSA infection within 17 days of colonization. For every 10-day increment in NICU stay, the odds ratio of being infected and colonized with MRSA increased by 1.32 and 1.29, respectively. Colonization was significantly associated with longer NICU stay, low birth weight, low gestational age, and multiple gestation status.Conclusion: Colonization is a risk factor for infection with MRSA in NICUs. Clinical cultures underestimate MRSA affected infants in NICUs, whereas active surveillance cultures could detect MRSA affected infants earlier and limit nosocomial spread.