Epidemiology and infection control of Methicillin-resistant Staphylococcus aureus in a German tertiary neonatal intensive and intermediate care unit: A retrospective study (2013-2020).
Carolin Böhne, Leonard Knegendorf, Frank Schwab, Ella Ebadi, Franz-Christoph Bange, Marius Vital, Dirk Schlüter, Gesine Hansen, Sabine Pirr, Corinna Peter, Bettina Bohnhorst, Claas Baier
Author Information
Carolin Böhne: Department of Pediatric Pulmonology, Allergology and Neonatology, Hannover Medical School (MHH), Hannover, Germany.
Leonard Knegendorf: Institute for Medical Microbiology and Hospital Epidemiology, Hannover Medical School (MHH), Hannover, Germany. ORCID
Frank Schwab: Institute of Hygiene and Environmental Medicine, Charité - University Medicine, Berlin, Germany.
Ella Ebadi: Institute for Medical Microbiology and Hospital Epidemiology, Hannover Medical School (MHH), Hannover, Germany.
Franz-Christoph Bange: Institute for Medical Microbiology and Hospital Epidemiology, Hannover Medical School (MHH), Hannover, Germany.
Marius Vital: Institute for Medical Microbiology and Hospital Epidemiology, Hannover Medical School (MHH), Hannover, Germany.
Dirk Schlüter: Institute for Medical Microbiology and Hospital Epidemiology, Hannover Medical School (MHH), Hannover, Germany.
Gesine Hansen: Department of Pediatric Pulmonology, Allergology and Neonatology, Hannover Medical School (MHH), Hannover, Germany.
Sabine Pirr: Department of Pediatric Pulmonology, Allergology and Neonatology, Hannover Medical School (MHH), Hannover, Germany.
Corinna Peter: Department of Pediatric Pulmonology, Allergology and Neonatology, Hannover Medical School (MHH), Hannover, Germany.
Bettina Bohnhorst: Department of Pediatric Pulmonology, Allergology and Neonatology, Hannover Medical School (MHH), Hannover, Germany.
Claas Baier: Institute for Medical Microbiology and Hospital Epidemiology, Hannover Medical School (MHH), Hannover, Germany. ORCID
In preterm and term infants who require intermediate or intensive care Methicillin-resistant Staphylococcus aureus (MRSA) infection can lead to significant morbidity. In this study MRSA colonization and infection were assessed in a mixed tertiary neonatal intensive and intermediate care unit in Germany over an 8-year period (2013-2020). We investigated patient-related factors, associated with nosocomial MRSA acquisition, and we discuss our infection control concept for MRSA. Of 3488 patients treated during the study period, 24 were MRSA positive patients, corresponding to 26 patient hospital stays. The incidence was 0.7 MRSA patients per 100 patients. The incidence density was 0.4 MRSA patient hospital stays per 1000 patient days. Twelve patients (50%) acquired MRSA in the hospital. One patient developed a hospital acquired MRSA bloodstream infection 9 days after birth (i.e., 0.03% of all patients on the ward during the study period). A total of 122 patients had to be screened to detect one MRSA positive patient. In a logistic regression model, the use of 3rd generation intravenous cephalosporin (cefotaxim) was associated with nosocomial MRSA acquisition compared with matched control patients who did not acquire MRSA. In sum, the burden of MRSA colonization and infection in the ward was low during the study period. A comprehensive infection control concept that included microbiologic colonization screening, prospective infection surveillance together with isolation and emphasis on basic hygiene measures is essential to handle MRSA in this specialized setting.
References
PLoS One. 2021 Jan 29;16(1):e0246343
[PMID: 33513178]
