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  • Quality Improvement Article
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Reducing Staphylococcus aureus infections in the neonatal intensive care unit

Journal of Perinatology volume 42, pages 1540–1545 (2022)Cite this article

Subjects

Abstract

Objective

Our neonatal intensive care unit (NICU) saw an increase in Staphylococcus aureus (SA) infections—methicillin-resistant SA (MRSA) infections increased from 2.1/10,000 patient days (PD) to 5.1/10,000 PD, and methicillin-sensitive SA (MSSA) infections from 1.2/10,000 PD to 3.9/10,000 PD. This quality improvement project aimed to decrease the rates of SA infections to less than 2.0/10,000 PD, and to determine the rate of SA decolonization.

Methods

Infection prevention interventions targeted patient factors (SA surveillance, patient cohorting, decolonization protocol), provider factors (provider cohorting, enhanced hand hygiene) and environmental factors (room structure, equipment optimization).

Results

The rates of MRSA and MSSA infections decreased to 0.6/10,000 PD and 0.7 infections/10,000 PD respectively. Persistent decolonization of SA was successful in 67% of colonized patients.

Conclusions

Specific interventions targeting patient, provider, and environmental factors, including the implementation of a SA decolonization protocol, were successful in decreasing the incidence of SA infections in neonates.

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Fig. 1: Fishbone Diagram.
Fig. 2: Decolonization Algorithm.
Fig. 3: SA Infection Run Chart.

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Author information

Authors and Affiliations

  1. Maternal, Fetal, and Neonatal Institute, Johns Hopkins All Children’s Hospital, St. Petersburg, FL, USA

    Noura Nickel & Sandra Brooks

  2. Infection Prevention, Johns Hopkins All Children’s Hospital, St. Petersburg, FL, USA

    Chris Mize & Allison Messina

Authors
  1. Noura Nickel
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  2. Sandra Brooks
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  3. Chris Mize
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  4. Allison Messina
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Contributions

NN conceptualized and designed the project, implemented the interventions, observed and recorded data, analyzed the data, interpreted the data, drafted the initial manuscript, revised the manuscript, approved the final version of the manuscript, and agreed to be accountable for all aspects of the work in ensuring that questions related to accuracy and integrity of the project were appropriately investigated and resolved. SB conceptualized and designed the project, implemented the interventions, interpreted the data, drafted the initial manuscript, revised the manuscript, approved the final version of the manuscript, and agreed to be accountable for all aspects of the work in ensuring that questions related to accuracy and integrity of the project were appropriately investigated and resolved. CM conceptualized and designed the project, implemented the interventions, observed and recorded data, analyzed the data, interpreted the data, revised the manuscript, approved the final version of the manuscript, and agreed to be accountable for all aspects of the work in ensuring that questions related to accuracy and integrity of the project were appropriately investigated and resolved. AM conceptualized and designed the project, implemented the interventions, interpreted the data, revised the manuscript, approved the final version of the manuscript, and agreed to be accountable for all aspects of the work in ensuring that questions related to accuracy and integrity of the project were appropriately investigated and resolved. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Noura Nickel.

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The authors declare no competing interests.

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Nickel, N., Brooks, S., Mize, C. et al. Reducing Staphylococcus aureus infections in the neonatal intensive care unit. J Perinatol 42, 1540–1545 (2022). https://doi.org/10.1038/s41372-022-01407-4

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