SEGRETI J, PUR S, PURPURA J, RICHARDS K, SCHMITT B; Interscience Conference on Antimicrobial Agents and Chemotherapy (43rd: 2003: Chicago, Ill.).

Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2003 Sep 14-17; 43: abstract no. K-582.

Rush Medical College, Chicago, IL.

BACKGROUND: MRSA is an unusual pathogen in NICU settings. When discovered, effective control measures need to be instituted quickly. We describe an outbreak of MRSA colonization/infection in our 46 bed NICU that was not controlled with usual infection control(IC) interventions, but was abated with use of intra-nasal mupirocin (INM) METHODS: A case was defined as hospitalization in the NICU during the outbreak period (Jan-April 2003)and positive clinical or nasal culture for MRSA. Infection was defined as isolation of MRSA from blood or sputum with signs of infection. Colonization was defined as isolation of MRSA from the nares without signs of infection. Infected and colonized infants were cohorted together. Cultures were obtained from the nares of HCW's and from working surfaces in the NICU. Isolates were analyzed by PFGE. RESULTS: A total of 23 infants were identified as infected (8) or colonized (15) with the outbreak strain (OS). 3 HCW's were colonized with MRSA, but only 1 had the OS. The OS was resistant to SXT, which is seen in < 5% of our MRSA isolates. A sample of these isolates had an identical PFGE pattern. New cases of MRSA colonization and infection were identified despite cohorting, treatment of the 3 HCW's with INM, universal gloving and improved hand hygiene (95% compliance). Cases were more likely than controls to have been transferred in, have a urinary catheter, have a feeding tube,have a sibling who was colonized/infected and have an IV. Contact with a colonized HCW and birth weight were not risk factors for infection/colonization. Because of apparent continuation of the outbreak, all infants in the NICU were treated with INM for 4 weeks and no new cases were identified. Routine INM was stopped and 3 weeks later, no new cases have been identified despite weekly monitoring of all infants in the NICU with nasal cultures. CONCLUSIONS: INM terminated an MRSA outbreak in our NICU that did not respond to usual IC interventions

Publication Types:

• Meeting Abstracts

Keywords:

• Communicable Diseases
• Disease Outbreaks
• Electrophoresis, Gel, Pulsed-Field
• Humans
• Infant
• Infant, Newborn
• Infection Control
• Intensive Care Units
• Intensive Care Units, Neonatal
• Mupirocin
• Nose
• Patient Isolation
• Risk Factors
• Staphylococcal Infections
• Staphylococcus aureus

Other ID:

• GWAIDS0026099

UI: 102265723

From Meeting Abstracts