%0 Journal Article %1 back_control_1996 %A Back, N A %A Linnemann, C C %A Staneck, J L %A Kotagal, U R %D 1996 %J Infection Control and Hospital Epidemiology: The Official Journal of the Society of Hospital Epidemiologists of America %K Agents, Care, Control, Cross Humans, Infant, Infection Infection, Infections, Intensive Methicillin Mupirocin, Neonatal, Newborn, Ohio, Resistance, Staphylococcal Staphylococcus aureus {Anti-Bacterial} %N 4 %P 227--231 %T Control of methicillin-resistant Staphylococcus aureus in a neonatal intensive-care unit: use of intensive microbiologic surveillance and mupirocin %U http://www.ncbi.nlm.nih.gov/pubmed/8935730 %V 17 %X OBJECTIVE: To describe the epidemiology and the interventions 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.

@article{back_control_1996, abstract = {{OBJECTIVE:} To describe the epidemiology and the interventions 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.}, added-at = {2011-03-11T10:05:34.000+0100}, author = {Back, N A and Linnemann, C C and Staneck, J L and Kotagal, U R}, biburl = {https://www.bibsonomy.org/bibtex/24adcd80111399ebba2c6ba50c127dc0b/jelias}, interhash = {7b429f423368e46653d5d3fa08ebfbab}, intrahash = {4adcd80111399ebba2c6ba50c127dc0b}, issn = {{0899-823X}}, journal = {Infection Control and Hospital Epidemiology: The Official Journal of the Society of Hospital Epidemiologists of America}, keywords = {Agents, Care, Control, Cross Humans, Infant, Infection Infection, Infections, Intensive Methicillin Mupirocin, Neonatal, Newborn, Ohio, Resistance, Staphylococcal Staphylococcus aureus {Anti-Bacterial}}, month = apr, note = {{PMID:} 8935730}, number = 4, pages = {227--231}, shorttitle = {Control of methicillin-resistant Staphylococcus aureus in a neonatal intensive-care unit}, timestamp = {2011-03-11T10:06:30.000+0100}, title = {Control of methicillin-resistant Staphylococcus aureus in a neonatal intensive-care unit: use of intensive microbiologic surveillance and mupirocin}, url = {http://www.ncbi.nlm.nih.gov/pubmed/8935730}, volume = 17, year = 1996 }