Methicillin resistant Staphylococcus aureus outbreak in a neonatal intensive care unit

Abstract

The global and national burden of communicable and noncommunicable diseases continues to rise, thus making access to Healthcare workers (HCWs) colonized with methicillin-resistant Staphylococcus aureus (MRSA) may pose transmission risk to vulnerable patients including neonates. This study reports an MRSA outbreak in a level-II neonatal intensive care unit (NICU) of a secondary care hospital in Pakistan. Once identified, an infection control team from the parent hospital visited the facility, risk factors were listed and infection control measures taken to control the outbreak. Screening cultures of NICU staff and environmental cultures from NICU were obtained for the presence of MRSA. Five neonates were positive for MRSA; one HCW was found to be colonized with MRSA, the antibiogram pattern of which matched with that of the outbreak strain. Decolonization of colonized HCWs and re-deployment from NICU to outpatient department were taken and the outbreak was declared over once no further MRSA cases were identified. Identification of an outbreak situation is the cornerstone for its control and multiple measures taken simultaneously help in curbing the outbreak. Although an epidemiological link was established with the HCW, a molecular link could not be proven.

Infection prevention and care bundles addressing health care-associated infections in neonatal care in low-middle income countries: a scoping review

“… 47 , 48 The rest were retrospective outbreak investigation studies. 12 , 22 , 24 , 31 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 36 (82%) and two (5%) studies were performed in tertiary or secondary inpatient neonatal care units, respectively. Six (14%) studies did not report their care level setting ( Table 1 ).…”

“… 20 , 27 , 44 The rest of the studies (39, 89%) described one bundle. The most common terms used in the publications to name the care bundles were ‘measures’ (13, 30%), 24 , 26 , 31 , 40 , 43 , 49 , 50 , 53 , 55 , 57 , 58 , 59 , 61 followed by ‘bundles’ (nine, 21%). 20 , 23 , 27 , 30 , 34 , 35 , 37 , 41 , 47 ( Figure 2 ).…”

“…In the outbreak control subgroup, 35 (47%) elements were aimed at the environment of the neonatal units, such as disinfection of areas and equipment or improving the organisation of the unit (e.g., use of a temporary ward, cohorting, or overcrowding reduction) (Table 3 in Appendix). 12 , 22 , 24 , 30 , 31 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 59 , 60 , 61 , 62 Additionally, 21 (28%) elements targeted the unit staff such as improving their hand hygiene or their use of protocols and policies. 9 (12%) elements were directed to the neonate such as their isolation, improving neonatal nutrition or local skin disinfection for venipuncture.…”

“…9 (12%) elements were directed to the neonate such as their isolation, improving neonatal nutrition or local skin disinfection for venipuncture. 22 , 30 , 49 , 50 , 53 , 55 , 57 , 58 There were no infection prevention and care bundles directly focused on the management and treatment of neonatal HCAI (e.g. no sepsis bundles) (not shown).…”

Multi-resistant Bacteria to Antibiotics in Hospitals: The Case of Neonatology Services of the University Hospitals Centers of Abidjan, Côte d'Ivoire

“…The most recent data for 85 WHO member countries reported rates exceeding 20% in all regions and even 80% in some countries [28]. MRSA has caused several hospital outbreaks in neonatal care units [29][30][31]. Reports from various studies have discussed the important risk factor of colonized caregivers in the occurrence of these outbreaks [32][33].…”