Staphylococcus aureus, including Community-Acquired Methicillin-resistant S. aureus, in a Level III NICU: 2001 to 2008

Rana, Divya; Abughali, Nazha; Kumar, Deepak; Super, Dennis M.; Jacobs, Michael; Kumar, Mary L.

doi:10.1055/s-0032-1304819

Cited by 20 publications

(13 citation statements)

References 33 publications

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“…This finding has been noted in other NICU studies. 2,37 The proportion of MRSA subsequently decreased from 2006 to 2012, however. Again, this has been demonstrated previously in both the pediatric 38 and adult populations.…”

Section: Discussionmentioning

confidence: 99%

Survival Benefit of Empirical Therapy for Staphylococcus aureus Bloodstream Infections in Infants

Thaden

Ericson²,

Cross

et al. 2015

Pediatric Infectious Disease Journal

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Background The impact of early adequate empirical antibiotic therapy on outcomes of infants in the neonatal intensive care unit (NICU) who develop Staphylococcus aureus bloodstream infection (BSI) is unknown. Methods Infants with S. aureus BSI discharged in 1997–2012 from 348 NICUs managed by the Pediatrix Medical Group were identified. Early adequate empirical antibiotic therapy was defined as exposure to ≥1 antibiotic with anti-staphylococcal activity on the day the first positive blood culture was obtained. All other cases were defined as inadequate empirical antibiotic therapy. We evaluated the association between inadequate empirical antibiotic therapy on outcomes controlling for gestational age, small-for-gestational-age status, gender, discharge year, mechanical ventilation, inotropic support, and use of supplemental oxygen. The primary outcome was 30-day mortality. Secondary outcomes were 7-day mortality, death before hospital discharge, and length of bacteremia. Results Of the 3339 infants with S. aureus BSI, 2492 (75%) had methicillin-susceptible S. aureus (MSSA) BSI and 847 (25%) had methicillin-resistant S. aureus (MRSA) BSI. Inadequate empirical antibiotic therapy was administered in 725 (22%) cases. Inadequate empirical antibiotic therapy was associated with increased 30-day mortality (odds ratio, 2.03 [95% confidence interval, 1.08, 3.82]) among infants with MRSA BSI. Inadequate empirical antibiotic therapy was not associated with increases in mortality among infants with MSSA BSI. Conclusions After controlling for confounders, inadequate empirical antibiotic therapy was associated with a modestly increased mortality at 30 days for infants with MRSA BSI.

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Section: Discussionmentioning

confidence: 99%

Survival Benefit of Empirical Therapy for Staphylococcus aureus Bloodstream Infections in Infants

Thaden

Ericson²,

Cross

et al. 2015

Pediatric Infectious Disease Journal

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“…17,18 A growing role of community-associated MRSA strains is reported in NICUs. 6,19,20 However, a meaningful distinction between health-care associated MRSA and community-acquired MRSA strains is increasingly challenging and MRSA strains previously identified as belonging to either group are reported to circulate in both community and health care settings. 14,21 Moreover, highly endemic community settings are likely to promote spilling of MRSA into the NICUs via HCWs or parents.…”

Section: Discussionmentioning

confidence: 99%

Methicillin-resistant Staphylococcus aureus nasal colonization in a level III neonatal intensive care unit: Incidence and risk factors

Giuffrè¹,

Amodio²,

Bonura³

et al. 2015

American Journal of Infection Control

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“…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%

New Threats from an Old Foe: Methicillin-Resistant <b><i>Staphylococcus aureus</i></b> 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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Staphylococcus aureus, including Community-Acquired Methicillin-resistant S. aureus, in a Level III NICU: 2001 to 2008

Abstract: The incidence of MRSA (colonization and infection) nearly doubled during the study period coinciding with emergence of community-acquired MRSA USA300.

Cited by 20 publications

References 33 publications

Survival Benefit of Empirical Therapy for Staphylococcus aureus Bloodstream Infections in Infants

Survival Benefit of Empirical Therapy for Staphylococcus aureus Bloodstream Infections in Infants

Methicillin-resistant Staphylococcus aureus nasal colonization in a level III neonatal intensive care unit: Incidence and risk factors

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

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