Burden of InvasiveStaphylococcus aureusInfections in Hospitalized Infants

Ericson, Jessica E.; Popoola, Victor O.; Smith, P. Brian; Benjamin, Daniel K.; Fowler, Vance G.; Clark, Reese H.; Milstone, Aaron M.

doi:10.1001/jamapediatrics.2015.2380

Cited by 90 publications

(80 citation statements)

References 39 publications

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“…It should be noted that clinical symptoms and signs at the onset of MRSA infections may be highly unspecific [23], underscoring the importance of close patient monitoring and timely access to laboratory and microbiological diagnostics. Currently, the mortality rate of MRSA infections varies widely among institutions, ranging from about 2.9 to 28% [3, 9, 19, 23]. Although there seems to be no difference between MRSA and methicillin-susceptible S. aureus in terms of their clinical presentation and mortality [3, 23, 28], neonates infected with MRSA may have a higher readmission rate and a longer infection course than MSSA cases [26, 29].…”

Section: Neonatal Mrsa Colonization and Infectionsmentioning

confidence: 99%

“…However, there is a considerable amount of data on S. aureus being the second most common pathogen of neonatal late-onset sepsis in certain countries [33], closely following coagulase-negative staphylococci [34]. As shown by limited population-based studies, the incidence of S. aureus infections may be 0.6 per 1,000 live births [23], 4.0–5.3 per 1,000 neonatal admissions, and 22 per 1,000 hospitalized very low BW (VLBW) infants [3, 23], with MRSA accounting for approximately 28% of all S. aureus infections [3, 26]. In VLBW infants, those with gram-positive bacterial infections had a significantly higher risk of bronchopulmonary dysplasia and cerebral palsy than their counterparts without infections [30-32].…”

Section: Neonatal Mrsa Colonization and Infectionsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Very immature preterm infants are particularly susceptible to MRSA infections, and neonates with a birth weight (BW) < 1,500 g may account for approximately 80% of all cases of neonatal MRSA infections [2, 3]. As demonstrated by a national cohort study in the USA, the incidence of infections due to MRSA remained stable over the last 2 decades at around 10 per 10,000 hospitalized infants, while that of infections caused by methicillin-susceptible Staphylococcus aureus remarkably decreased [3]. Moreover, recent epidemiologic studies have shed light on evolving MRSA clones and the increasing resistance of MRSA to antimicrobi al substances, indicating the remarkable adaptability of MRSA to anti-infective strategies and its significance as a successful global pathogen [4].…”

Section: Introductionmentioning

confidence: 99%

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New Threats from an Old Foe: Methicillin-Resistant Staphylococcus aureus Infections in Neonates

2018

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Methicillin-resistant Staphylococcus aureus (MRSA) is a ubiquitous human inhabitant and one of the important pathogens of neonatal infections. MRSA is associated with significant mortality and morbidity, especially in very immature preterm neonates. Moreover, MRSA may be implicated in adverse long-term neonatal outcomes, posing a substantial disease burden. Recent advances in molecular microbiology have shed light on the evolution of MRSA population structure and virulence factors, which may contribute to MRSA epidemic waves worldwide. Equipped with remarkable genetic flexibility, MRSA has successfully developed resistance to an extensive range of antibiotics including vancomycin, as well as antiseptics. In the face of these new challenges from MRSA, our armamentarium of anti-infective strategies is very limited and largely dependent on prevention measures. Active surveillance cultures followed by decolonization may be a promising approach to control MRSA infections, with its efficacy and safety in the specific population of neonates yet to be addressed by large multicenter studies.

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Section: Neonatal Mrsa Colonization and Infectionsmentioning

confidence: 99%

Section: Neonatal Mrsa Colonization and Infectionsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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New Threats from an Old Foe: Methicillin-Resistant Staphylococcus aureus Infections in Neonates

2018

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“…Hence, infection control practices in many centres concentrate on the identification of infants colonized with MRSA but not those colonized with MSSA [8]. Recently, similar morbidity and mortality rates were described in VLBWI infected with MRSA and MSSA, underlining the potential benefit of implementing infection control policies, even in units without endemic MRSA [6,9]. …”

Section: Introductionmentioning

confidence: 99%

Active Surveillance Cultures and Targeted Decolonization Are Associated with Reduced Methicillin-Susceptible Staphylococcus aureus Infections in VLBW Infants

et al. 2017

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Background: Methicillin-susceptible Staphylococcus aureus (MSSA) is a major contributor to infectious episodes of very low birth weight infants (VLBWI), resulting in significant morbidity and mortality. Objective: To examine the efficacy and safety of surveillance cultures and the decolonization of MSSA-colonized VLBWI. Methods: VLBWI admitted to our neonatal wards in 2011-2016 were retrospectively analyzed. Rates of MSSA-attributable infections were compared before and after the implementation of active surveillance cultures and the decolonization of MSSA-colonized patients. The mupirocin susceptibility of isolated MSSA strains was routinely tested. Results: A total of 1,056 VLBWI were included in the study, 552 in the pre-intervention period and 504 in the post-intervention period. The implementation of surveillance cultures and decolonization of colonized patients resulted in a 50% reduction of incidence rates per 1,000 patient-days of MSSA-attributable infections (1.63 [95% CI 1.12-2.31] vs. 0.83 [95% CI 0.47-1.35], p = 0.024). No adverse effects were observed from application of the decolonization protocol with mupirocin and octenidin. No mupirocin-resistant MSSA strains were detected during the study period. Conclusion: Implementation of an active surveillance and decolonization protocol resulted in a reduction of MSSA-attributable infections in VLBWI.

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Decreasing Staphylococcus aureus in the Neonatal Intensive Care Unit by Decolonizing Parents

Zachariah

Saiman

2020

JAMA

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Burden of InvasiveStaphylococcus aureusInfections in Hospitalized Infants

Cited by 90 publications

References 39 publications

New Threats from an Old Foe: Methicillin-Resistant <b><i>Staphylococcus aureus</i></b> Infections in Neonates

New Threats from an Old Foe: Methicillin-Resistant <b><i>Staphylococcus aureus</i></b> Infections in Neonates

Active Surveillance Cultures and Targeted Decolonization Are Associated with Reduced Methicillin-Susceptible <b><i>Staphylococcus aureus</i></b> Infections in VLBW Infants

Decreasing Staphylococcus aureus in the Neonatal Intensive Care Unit by Decolonizing Parents

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