Methicillin-Resistant Staphylococcus aureus Colonization and Risk of Subsequent Infection in Critically Ill Children: Importance of Preventing Nosocomial Methicillin-Resistant Staphylococcus aureus Transmission

Milstone, Aaron M.; Goldner, Brian W.; Ross, Tracy; Shepard, John; Carroll, Karen C.; Perl, Trish M.

doi:10.1093/cid/cir547

Cited by 72 publications

(56 citation statements)

References 39 publications

(53 reference statements)

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“…Review of the reference lists of all the included articles yielded 1 additional eligible study. Among the 18 eligible studies, 2 had partially overlapping data, 24,25 and the maximum relevant information was extracted (Fig 1).…”

Section: Resultsmentioning

confidence: 99%

“…[24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] The studies provided screening data on 19 722 neonatal and pediatric patients. More specifically, 11 studies reported data on 12 284 screened neonates in 12 NICUs, whereas 6 studies reported data on 7107 children hospitalized in 6 PICUs.…”

Section: Figurementioning

confidence: 99%

“…33 In studies that reported data stratified by year or ICU setting, data sets were split to discrete strata and considered separately. 24,28,34,35,38 The majority of the included studies (11 of 18) were prospective, and the remaining 7 were retrospective.…”

Section: Figurementioning

confidence: 99%

“…Seven of 18 studies (4 that included NICU patients and 3 that included PICU patients) 24,[26][27][28][29]31,35 followed the patients until their discharge, transfer to another facility, or death and provided data on the development of MRSA infections. The data of each individual study are summarized in Table 3.…”

Section: Figurementioning

confidence: 99%

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MRSA Colonization and Risk of Infection in the Neonatal and Pediatric ICU: A Meta-analysis

Zervou

Zacharioudakis

Ziakas³

et al. 2014

Pediatrics

102

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BACKGROUND AND OBJECTIVE: Methicillin-resistant Staphylococcus aureus (MRSA) is a significant cause of morbidity and mortality in NICUs and PICUs. Our objective was to assess the burden of MRSA colonization on admission, study the time trends, and examine the significance of MRSA colonization in this population. METHODS:PubMed and Embase databases were consulted. Studies that reported prevalence of MRSA colonization on ICU admission were selected. Two authors independently extracted data on MRSA colonization and infection. RESULTS:We identified 18 suitable articles and found an overall prevalence of MRSA colonization of 1.9% (95% confidence interval [CI] 1.3%-2.6%) on admission to the NICU or PICU, with a stable trend over the past 12 years. Interestingly, 5.8% (95% CI 1.9%-11.4%) of outborn neonates were colonized with MRSA on admission to NICU, compared with just 0.2% (95% CI 0.0%-0.9%) of inborn neonates (P = .01). The pooled acquisition rate of MRSA colonization was 4.1% (95% CI 1.2%-8.6%) during the NICU and PICU stay and was as high as 6.1% (95% CI 2.8%-10.6%) when the NICU population was studied alone. There was a relative risk of 24.2 (95% CI 8.9-66.0) for colonized patients to develop a MRSA infection during hospitalization. CONCLUSIONS:In the NICU and PICU, there are carriers of MRSA on admission, and MRSA colonization in the NICU is almost exclusively associated with outborn neonates. Importantly, despite infection control measures, the acquisition rate is high, and patients colonized with MRSA on admission are more likely to suffer a MRSA infection during hospitalization.

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Section: Resultsmentioning

confidence: 99%

Section: Figurementioning

confidence: 99%

Section: Figurementioning

confidence: 99%

Section: Figurementioning

confidence: 99%

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MRSA Colonization and Risk of Infection in the Neonatal and Pediatric ICU: A Meta-analysis

Zervou

Zacharioudakis

Ziakas³

et al. 2014

Pediatrics

102

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“…13 Reported nasal carriage rates of MRSA from children vary from one country to another and within the same country depending on populations studied and associated risk factors with lower nasal carriage rates being reported from healthy children. A Brazilian study reported a nasal carriage rate of 31.1% (371 of 1,192) for S. aureus and 1.2% (14 of 1,192) for MRSA among healthy children 5 years of age or less attending 62 day care centers.…”

Section: Discussionmentioning

confidence: 99%

Nasal Carriage of Multi-Drug Resistant Panton-Valentine Leucocidin-Positive Methicillin-Resistant Staphylococcus aureus in Children in Tripoli-Libya

Al-haddad

Zorgani

Ghenghesh

2014

The American Society of Tropical Medicine and Hygiene

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Abstract. Methicillin-resistant Staphylococcus aureus (MRSA) colonized children are at an increased risk of developing infections than methicillin-sensitive S. aureus colonized children. Nasal specimens from inpatient children, mothers of inpatient children, healthcare workers, and outpatient children at Tripoli Children Hospital (TCH) were examined for MRSA by chromogenic MRSA ID medium. Susceptibility of MRSA isolates to antibiotics was determined by the disc diffusion method. The nasal carriage rate of MRSA among inpatient children (8.3%, 24 of 289), their mothers (11%, 22 of 200), and healthcare workers (12.4%, 22 of 178) was significantly higher than among outpatient children (2.2%, 2 of 91) (P 0.05, P 0.02, and P 0.006, respectively). Of the examined MRSA isolates (N = 35) 10 (28.6%) were positive for Panton-Valentine leucocidin genes by polymerase chain reaction. Multidrug resistance was found in 24.3% (17 of 70) of MRSA isolates. Nasal carriage of multidrug-resistant Panton-Valentine leucocidin-positive MRSA is not uncommon among inpatient children and their mothers in Tripoli.

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Surveillance for Colonization, Transmission, and Infection With Methicillin-Susceptible Staphylococcus aureus in a Neonatal Intensive Care Unit

et al. 2021

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Key Points Question What are the risk factors for the acquisition of methicillin-susceptible Staphylococcus aureus (MSSA) colonization and infections in a neonatal intensive care unit? Findings In this cohort study of 590 newborns, the acquisition of S aureus colonization and infection was monitored until hospital discharge. Colonization with MSSA was associated with lower birth weight, longer hospitalization, and higher odds of acquiring S aureus infection during hospitalization. Meaning These findings suggest that nasal colonization is a relevant risk factor for MSSA infection in a nonoutbreak neonatal intensive care unit setting.

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Methicillin-Resistant Staphylococcus aureus Colonization and Risk of Subsequent Infection in Critically Ill Children: Importance of Preventing Nosocomial Methicillin-Resistant Staphylococcus aureus Transmission

Cited by 72 publications

References 39 publications

MRSA Colonization and Risk of Infection in the Neonatal and Pediatric ICU: A Meta-analysis

MRSA Colonization and Risk of Infection in the Neonatal and Pediatric ICU: A Meta-analysis

Nasal Carriage of Multi-Drug Resistant Panton-Valentine Leucocidin-Positive Methicillin-Resistant Staphylococcus aureus in Children in Tripoli-Libya

Surveillance for Colonization, Transmission, and Infection With Methicillin-Susceptible Staphylococcus aureus in a Neonatal Intensive Care Unit

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