Objective

To assess the impact of active surveillance and decolonization strategies on methicillin-resistant Staphylococcus aureus (MRSA) infection rates in a NICU.

Study design

MRSA infection rates were compared before (2014–2016) and during (2017–2022) an active surveillance program. Eligible infants were decolonized with chlorohexidine gluconate (CHG) bathing and/or topical mupirocin. Successful decolonization and rates of recolonization were assessed.

Results

Fifty-two (0.57%) of 9 100 hospitalized infants had invasive MRSA infections from 2014 to 2022; infection rates declined non-significantly. During the 6-year surveillance program, the risk of infection was 16.9-times [CI₉₅ 8.4, 34.1] higher in colonized infants than uncolonized infants. Those colonized with mupirocin-susceptible MRSA were more likely successfully decolonized (aOR 9.7 [CI₉₅ 4.2, 22.5]). Of 57 infants successfully decolonized who remained hospitalized, 34 (60%) became recolonized.

Conclusions

MRSA infection rates did not significantly decline in association with an active surveillance and decolonization program. Alternatives to mupirocin and CHG are needed to facilitate decolonization.

中文翻译：

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新生儿重症监护病房中耐甲氧西林金黄色葡萄球菌主动监测和去定植策略的影响

客观的

评估主动监测和去定植策略对 NICU 中耐甲氧西林金黄色葡萄球菌(MRSA) 感染率的影响。

学习规划

对主动监测计划之前（2014-2016 年）和期间（2017-2022 年）MRSA 感染率进行了比较。符合条件的婴儿通过葡萄糖酸氯己定 (CHG) 沐浴和/或局部莫匹罗星进行去定植。评估了成功的去殖民化和再殖民化率。

结果

2014年至2022年，9 100名住院婴儿中有52名（0.57%）患有侵袭性MRSA感染；感染率下降幅度不大。在为期 6 年的监测计划中，定植婴儿的感染风险是未定植婴儿的16.9 倍 [CI ₉₅ 8.4, 34.1]。那些被莫匹罗星敏感 MRSA 定植的人更有可能成功去定植 (aOR 9.7 [CI ₉₅ 4.2, 22.5])。在 57 名成功去定植但仍在住院的婴儿中，有 34 名（60%）重新定植。

结论

MRSA 感染率并未因积极监测和去定植计划而显着下降。需要莫匹罗星和 CHG 的替代品来促进去殖民化。