Trends in Incidence of Late-Onset Methicillin-Resistant Staphylococcus aureus Infection in Neonatal Intensive Care Units Data From the National Nosocomial Infections Surveillance System, 1995-2004
Trends in Incidence of Late-Onset Methicillin-Resistant Staphylococcus aureus Infection in Neonatal Intensive Care Units Data From the National Nosocomial Infections Surveillance System, 1995-2004
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DOI：
10.1097/inf.0b013e31819988bf
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发表时间：
2009-07-01
影响因子：
3.6
通讯作者：
Gorwitz, Rachel J.
中科院分区：
文献类型：
--
作者：
Lessa, Fernanda C.;Edwards, Jonathan R.;Gorwitz, Rachel J.
背景：越来越多地据报道，耐甲氧西林金黄色葡萄球菌（MRSA）在新生儿重症监护病房（NICUS）引起爆发。我们评估了NICUS中的3天后（晚期发作MRSA感染）后MRSA感染疾病发作的范围和大小。方法：我们分析了NICUS报告的数据，该数据参与了1995年至2004年。监视月，所有与医疗保健相关的感染所定义据报道，标准以及分离株的抗菌敏感性模式。我们按出生体重类别和日历年汇集了所有NICUS的数据。泊松回归用于评估每10,000例患者日期发病率MRSA感染的发生率的变化。分析：总体上，149个NICUS报告了4831 S.金黄色葡萄球菌感染和5,878,139例患者日。甲氧西林测试数据可用于4302 S.金黄色分离株，其中975（23％）为MRSA。每10,000例患者周期的MRSA感染的发病率，将所有出生体重类别结合起来，从1995年的0.7增加到308％增加到2004年的3.1（p <0.001）。在分别分析的所有4种出生体重类别中，MRSA感染的发生率显着增加（2500 g）。在研究期间，通过感染类型的MRSA感染分布没有变化。 299（31％）的MRSA感染是血液感染，174（18％）为肺炎，161（17％）是结膜炎：结论：在1995年至2004年之间，晚期MRSA感染的发生率大大增加，表明需要加强感染控制建议并探索潜在的传播来源和途径。
Background: Methicillin-resistant Staphylococcus aureus (MRSA) is increasingly being reported to cause outbreaks in neonatal intensive care units (NICUs). We assessed the scope and magnitude of MRSA infections with disease onset after 3 days of age (late-onset MRSA infections) in NICUs.Methods: We analyzed data reported by NICUs participating in the National Nosocomial Infections Surveillance system from 1995 through 2004. For each surveillance month, all healthcare-associated infections as defined by National Nosocomial Infections Surveillance criteria were reported, along with antimicrobial susceptibility patterns of the isolates. We pooled the data from all NICUs by birth weight category and calendar year. Poisson regression was used to assess changes in incidence of late-onset MRSA infections per 10,000 patient-days.Results: Overall, 149 NICUs reported 4831 S. aureus infections and 5,878,139 patient-days. Methicillin testing data were available for 4302 S. aureus isolates, of which 975 (23%) were MRSA. Incidence of late-onset MRSA infection per 10,000 patient-days, combining all birthweight categories, increased 308% from 0.7 in 1995 to 3.1 in 2004 (P < 0.001). A significant increase in incidence of MRSA infections was observed among all 4 birthweight categories analyzed separately (2500 g). The distribution of MRSA infection by type of infection did not vary during the study period; 299 (31%) of MRSA infections were bloodstream infections, 174 (18%) were pneumonia, and 161 (17%) were conjunctivitis.Conclusion: The incidence of late-onset MRSA infections increased substantially between 1995 and 2004, indicating a need to reinforce infection control recommendations and to explore potential sources and routes of transmission.