The effect of routine surveillance and decolonization on the rate of Staphylococcus aureus infections in a level IV neonatal intensive care unit

Abstract

Objective

To evaluate the impact of active surveillance cultures (ASC) for Staphylococcus aureus (SA) and decolonization on the rate of infection in neonates in a neonatal intensive care unit (NICU).

Study design

Using a quasi-experimental design with control groups, rates of SA infections before and after implementing weekly ASC and topical mupirocin decolonization in a level IV NICU were compared. Comparators were the rates of gram negative bloodstream infections (BSI) and of SA BSI at an affiliated NICU where the intervention was not implemented.

Result

There was a 77% (p < 0.010) reduction in rate of NICU-wide methicillin-susceptible SA (MSSA) BSI, but no significant change in rate of methicillin-resistant SA BSI, likely due to a prevalent mupirocin-resistant clone. Rates of gram negative BSI and SA BSI at an affiliated NICU did not change significantly.

Conclusion

Weekly ASC and decolonization were associated with a unit-wide reduction in MSSA infections in a NICU.

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Fig. 1: Epidemic curve of monthly MSSA (top panel) and MRSA (bottom panel) clinical infections (light grey bars) and bloodstream infections (dark grey bars) during the preintervention and intervention periods.

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Acknowledgements

We would like to thank the staff of the microbiology lab of the Long Island Jewish Medical Center, Northwell Health, New Hyde Park, New York for their support and cooperation.

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AB conceptualized the study, designed the data collection instruments, collected data, drafted the initial paper and reviewed and revised the paper. LGR conceptualized and designed the study, coordinated and supervised data collection, and critically reviewed the paper for important intellectual concept. JB conceptualized and designed the study and reviewed and revised the paper. NK supervised the data collection instruments, carried out the statistical analyses and reviewed and revised the paper.

Corresponding author

Correspondence to Archana Balamohan.

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Balamohan, A., Beachy, J., Kohn, N. et al. The effect of routine surveillance and decolonization on the rate of Staphylococcus aureus infections in a level IV neonatal intensive care unit. J Perinatol (2020). https://doi.org/10.1038/s41372-020-0755-5

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