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Spa Typing of Staphylococcus aureus in a Neonatal Intensive Care Unit During Routine Surveillance.

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  • معلومة اضافية
    • المصدر:
      Publisher: Oxford University Press Country of Publication: England NLM ID: 101586049 Publication Model: Print Cited Medium: Internet ISSN: 2048-7207 (Electronic) Linking ISSN: 20487193 NLM ISO Abbreviation: J Pediatric Infect Dis Soc Subsets: MEDLINE
    • بيانات النشر:
      Original Publication: Oxford : Oxford University Press
    • الموضوع:
      Methicillin-Resistant Staphylococcus aureus*/genetics ; Staphylococcal Infections*/diagnosis ; Staphylococcal Infections*/drug therapy ; Staphylococcal Infections*/epidemiology; Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Humans ; Infant ; Infant, Newborn ; Intensive Care Units, Neonatal ; Mupirocin ; Staphylococcus aureus/genetics
    • نبذة مختصرة :
      Background: Staphylococcus aureus protein A (spa) typing can be used to expand characterization of the epidemiology of methicillin-susceptible S. aureus (MSSA) and methicillin-resistant S. aureus (MRSA) in neonatal intensive care units (NICU).
      Methods: From January 2017 to June 2018, twice-monthly surveillance for S. aureus was performed in an academically affiliated NICU. Decolonization of infants colonized with S. aureus included chlorhexidine gluconate bathing and/or mupirocin for those with mupirocin-susceptible strains. Spa typing and mupirocin-resistance testing were performed. Demographic and clinical characteristics were compared between infants colonized with MSSA vs MRSA and infants with and without the most common MSSA spa type, MSSA-t279.
      Results: Overall, 14% and 2% of 1556 hospitalized infants had positive surveillance cultures for MSSA and MRSA, respectively. Thirty-six infants harbored unique MSSA spa types, 5 infants harbored unique MRSA spa types, and 30 MSSA and 6 MRSA spa types were identified in ≥2 infants. No outbreaks were identified during the study period. MSSA-t279 was isolated from 3% of infants and largely detected from infants hospitalized in one section of the NICU; 96% of t279 isolates were mupirocin resistant. Infection rates, length of hospitalization, and mortality were similar among infants initially colonized with t279 vs other MSSA spa types.
      Conclusions: The MSSA colonization burden was 5-fold larger than that of MRSA. Numerous unique spa types were identified. The most common spa type, MSSA-t279, was not associated with increased morbidity or mortality but was mupirocin resistant and associated with clustered NICU beds. This suggests potential transmission from the environment, shared staff, and/or workflow issues requiring further study. Other decolonization strategies for S. aureus in the NICU are needed.
      (© The Author(s) 2021. Published by Oxford University Press on behalf of The Journal of the Pediatric Infectious Diseases Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
    • Grant Information:
      TL1 TR001875 United States TR NCATS NIH HHS; TL1 TR001875 United States NH NIH HHS
    • Contributed Indexing:
      Keywords: spa-type 279; decolonization; methicillin-resistant S. aureus; methicillin-susceptible Staphylococcus aureus; mupirocin resistance; neonatal intensive care unit (NICU); staphylococcal protein A (spa-) typing
    • الرقم المعرف:
      0 (Anti-Bacterial Agents)
      D0GX863OA5 (Mupirocin)
    • الموضوع:
      Date Created: 20210615 Date Completed: 20210916 Latest Revision: 20220716
    • الموضوع:
      20250114
    • الرقم المعرف:
      PMC8370566
    • الرقم المعرف:
      10.1093/jpids/piab014
    • الرقم المعرف:
      34129043