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Control of Methicillin-Resistant Staphylococcus aureus in a Neonatal Intensive-Care Unit: Use of Intensive Microbiologic Surveillance and Mupirocin

Published online by Cambridge University Press:  02 January 2015

Nancy A. Back ,
Calvin C. Linnemann Jr ,
Joseph L. Staneck  and
Uma R. Kotagal
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Abstract

Objective:

To describe the epidemiology and the inter ventions used to control two methicillin-resistant Staphylococcus aureus (MRSA) epidemics involving 46 infants with two fatalities in a neonatal intensive care unit (NICU).

Setting:

A 50-bed, level III NICU in a university hospital.

Interventions:

After traditional interventions failed to stop the first epidemic, an intensive microbiologic surveillance (IMS) program was developed. Cultures were obtained on all infants each week, and those colonized with MRSA were isolated. When an infant was found to be colonized with MRSA, cultures immediately were obtained on all surrounding infants. This was continued until no MRSA-colonized infants were found in the area. During the first epidemic, mupirocin was used in an attempt to eradicate the organism from the unit.

Results:

All infants, colonized and noncolonized, and parents of and personnel working with colonized infants were treated simultaneously with 5 days of mupirocin. This failed to eradicate MRSA in colonized infants. The spread of MRSA ceased in the unit, but a second epidemic occurred 4 months later. This time, IMS alone was successful in quickly containing the epidemic, and MRSA disappeared from the unit after all colonized infants were discharged. Plasmid analysis demonstrated that the same strain was responsible for both outbreaks.

Conclusions:

IMS and isolation are effective in containing the spread of MRSA in an NICU. The use of mupirocin failed to eradicate the organism.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 17 , Issue 4 , April 1996 , pp. 227 - 231
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1996 

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