Non-Multidrug-Resistant, Methicillin-Resistant Staphylococcus aureus in a Neonatal Unit

Author(s):Show less -

Garcia, Cilmara P. ^{[1, 2]} ; Rosa, Juliana F. ^{[1, 2]} ; Cursino, Maria A. ^{[1, 2]} ; Lobo, Renata D. ^[3] ; Mollaco, Carla H. ^[3] ; Gobara, Satiko ^[3] ; Malieno, Paula B. ^{[1, 2]} ; Raymundo, Gabriela F. ^{[1, 2]} ; Soares, Robson E. ^{[1, 2]} ; Keil, Kleiste G. ^{[1, 2]} ; Toma, Edi ^[4] ; Salomao, Matias C. ^{[1, 2]} ; Helena Matte, M. ^[5] ; Krebs, Vera L. ^[4] ; Augusta Gibelli, M. ^[4] ; Kondo, Mario M. ^[6] ; Zugaib, Marcelo ^[6] ; Costa, Silvia F. ^{[7, 1, 2]} ; Levin, Anna S. ^{[7, 1, 2, 3]}

Affiliation

^[1] Univ Sao Paulo, Hosp Clin, Dept Infect Dis, Sao Paulo - Brazil

^[2] Univ Sao Paulo, Hosp Clin, LIM 54, Sao Paulo - Brazil

^[3] Univ Sao Paulo, Hosp Clin, Dept Infect Control, Sao Paulo - Brazil

^[4] Univ Sao Paulo, Dept Pediat, Sao Paulo - Brazil

^[5] Univ Sao Paulo, Fac Publ Hlth, Sao Paulo - Brazil

^[6] Univ Sao Paulo, Dept Obstet, Sao Paulo - Brazil

^[7] Univ Sao Paulo, Inst Med Trop Sao Paulo, Sao Paulo - Brazil

• Document type: Journal article
• Source: PEDIATRIC INFECTIOUS DISEASE JOURNAL; v. 33, n. 10, p. E252-E259, OCT 2014.
• Web of Science Citations: 3

Abstract

Background: In the last decade, non-multiresistant methicillin-resistant Staphylococcus aureus (NM-MRSA) has been described as an important agent in bloodstream infections in our hospital. Methods: This prospective cohort study, conducted from February 2009 through January 2010 in the neonatal unit, evaluated 403 newborns (NB), their 382 mothers and 148 health care workers (HCW). Results: Approximately 217 NB (54%), 187 mothers (48%) and 87 HCW (59%) were colonized by S. aureus (SA). MRSA colonization was greater among NB (15%) than mothers (4.7%) and HCW (3.4%). Although mother-to-NB transmission occurred, in most cases mothers were not responsible for NB colonization. There were 2 predominant PFGE patterns among the NB and some mothers and HCW became colonized by them. Factors significantly associated with MRSA carriage by NB were lower level of maternal schooling (risk factor: odds ratio: 2.99; 95% confidence interval: 1.10-8.07) and maternal rhinosinusitis (protective factor: odds ratio: 0.33; 95% confidence interval: 0.12-0.88). Among NB who remained hospitalized for more than 72 hours, breast feeding was protective (odds ratio: 0.22; 95% confidence interval: 0.05-0.98). All the isolates were NM-MRSA, carried few virulence factors and SCCmec types IVa and type IVd predominated. Conclusions: Although there were no cases of infection, nosocomial transmission of MRSA clearly occurred in the neonatal unit, and this highlights the need for infection control practices such as hand hygiene to prevent cross-dissemination. Other healthcare practices, which are very basic but also ample in scope, may play a role, such as general education of women and breast feeding. (AU)

• FAPESP's process: 09/07746-2 - Evaluation of the prevalence of methicillin-resistant S. aureus in newborns and their mothers
• Grantee: Matias Chiarastelli Salomão
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• FAPESP's process: 09/08206-1 - Factors associated with acquiring methicillin-resistant Staphylococcus aureus in newborns
• Grantee: Anna Sara Shafferman Levin
• Support Opportunities: Regular Research Grants