TY - JOUR
T1 - Active surveillance cultures and decolonization to reduce staphylococcus aureus infections in the neonatal intensive care unit
AU - Popoola, Victor O.
AU - Colantuoni, Elizabeth
AU - Suwantarat, Nuntra
AU - Pierce, Rebecca
AU - Carroll, Karen C.
AU - Aucott, Susan W.
AU - Milstone, Aaron M.
N1 - Publisher Copyright:
© 2016 by The Society for Healthcare Epidemiology of America.
PY - 2016/4/1
Y1 - 2016/4/1
N2 - background. Staphylococcus aureus is a common cause of healthcare-associated infections in neonates. objective. To examine the impact of methicillin-susceptible S. aureus (MSSA) decolonization on the incidence of MSSA infection and to measure the prevalence of mupirocin resistance. methods. We retrospectively identified neonates admitted to a tertiary care neonatal intensive care unit (NICU) from April 1, 2011, through September 30, 2014.We compared rates of MSSA-positive cultures and infections before and after implementation of an active surveillance culture and decolonization intervention for MSSA-colonized neonates. We used 2 measurements to identify the primary outcome, NICU-attributable MSSA: (1) any culture sent during routine clinical care that grew MSSA and (2) any culture that grew MSSA and met criteria of the National Healthcare Safety Network's healthcare-associated infection surveillance definitions. S. aureus isolates were tested for mupirocin susceptibility. We estimated incidence rate ratios using interrupted time-series models. results. Before and after the intervention, 1,523 neonates (29,220 patient-days) and 1,195 neonates (22,045 patient-days) were admitted to the NICU, respectively. There was an immediate reduction in the mean quarterly incidence rate of NICU-attributable MSSA-positive clinical cultures of 64% (incidence rate ratio, 0.36 [95% CI, 0.19-0.70]) after implementation of the intervention, and MSSA-positive culture rates continued to decrease by 21% per quarter (incidence rate ratio, 0.79 [95% CI, 0.74-0.84]). MSSA infections also decreased by 73% immediately following the intervention implementation (incidence rate ratio, 0.27 [95% CI, 0.10-0.79]). No mupirocin resistance was detected. conclusion. Active surveillance cultures and decolonization may be effective in decreasing S. aureus infections in NICUs.
AB - background. Staphylococcus aureus is a common cause of healthcare-associated infections in neonates. objective. To examine the impact of methicillin-susceptible S. aureus (MSSA) decolonization on the incidence of MSSA infection and to measure the prevalence of mupirocin resistance. methods. We retrospectively identified neonates admitted to a tertiary care neonatal intensive care unit (NICU) from April 1, 2011, through September 30, 2014.We compared rates of MSSA-positive cultures and infections before and after implementation of an active surveillance culture and decolonization intervention for MSSA-colonized neonates. We used 2 measurements to identify the primary outcome, NICU-attributable MSSA: (1) any culture sent during routine clinical care that grew MSSA and (2) any culture that grew MSSA and met criteria of the National Healthcare Safety Network's healthcare-associated infection surveillance definitions. S. aureus isolates were tested for mupirocin susceptibility. We estimated incidence rate ratios using interrupted time-series models. results. Before and after the intervention, 1,523 neonates (29,220 patient-days) and 1,195 neonates (22,045 patient-days) were admitted to the NICU, respectively. There was an immediate reduction in the mean quarterly incidence rate of NICU-attributable MSSA-positive clinical cultures of 64% (incidence rate ratio, 0.36 [95% CI, 0.19-0.70]) after implementation of the intervention, and MSSA-positive culture rates continued to decrease by 21% per quarter (incidence rate ratio, 0.79 [95% CI, 0.74-0.84]). MSSA infections also decreased by 73% immediately following the intervention implementation (incidence rate ratio, 0.27 [95% CI, 0.10-0.79]). No mupirocin resistance was detected. conclusion. Active surveillance cultures and decolonization may be effective in decreasing S. aureus infections in NICUs.
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U2 - 10.1017/ice.2015.316
DO - 10.1017/ice.2015.316
M3 - Article
C2 - 26725699
AN - SCOPUS:84961744597
SN - 0899-823X
VL - 37
SP - 381
EP - 387
JO - Infection control and hospital epidemiology
JF - Infection control and hospital epidemiology
IS - 4
ER -