Observational studyThe Journal of hospital infection2017
Meticillin-resistant Staphylococcus aureus (MRSA) acquisition risk in an endemic neonatal intensive care unit with an active surveillance culture and decolonization programme.
Observational study in The Journal of hospital infection, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Transmission routes of antibiotic resistant bacteria: a systematic review.BMC infectious diseases · 2022Pooled it
- Trial
- Mupirocin forPediatrics · 2019Trial
- Neonatal Unit Colonization Pressure and Acquisition of Extended-Spectrum β-Lactamase Gut Colonization.JAMA network open · 2026Article
- Epidemiology and antimicrobial resistance analysis of staphylococcus aureus isolated from women, children and neonates in a maternal and child specialty hospital in Southeast China.BMC infectious diseases · 2026Article
- Investigation and control of a meticillin-resistantInfection prevention in practice · 2026Article
- Infection of neonates withMicrobiology spectrum · 2025Article
- Epidemiology and Mortality of Invasive Staphylococcus aureus Infections in Hospitalized Infants.JAMA pediatrics · 2025Article
- Impact of active surveillance and decolonization strategies for methicillin-resistant Staphylococcus aureus in a neonatal intensive care unit.Journal of perinatology : official journal of the California Perinatal Association · 2024Article
- Management and Prevention of Staphylococcus aureus Infections in Children.Infectious disease clinics of North America · 2022Review
- One Health in hospitals: how understanding the dynamics of people, animals, and the hospital built-environment can be used to better inform interventions for antimicrobial-resistant gram-positive infections.Antimicrobial resistance and infection control · 2020Review
- Whole-genome sequencing data-based modeling for the investigation of an outbreak of community-associated methicillin-resistant Staphylococcus aureus in a neonatal intensive care unit in Hong Kong.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2019Article
- Impact of MRSA Transmission and Infection in a Neonatal Intensive Care Unit in China: A Bundle Intervention Study during 2014-2017.BioMed research international · 2019Article
- Epidemiology and risk factors for recurrent Staphylococcus aureus colonization following active surveillance and decolonization in the NICU.Infection control and hospital epidemiology · 2018Article
- Evaluating a neonatal intensive care unit MRSA surveillance programme using agent-based network modelling.The Journal of hospital infection · 2018Article
- Healthcare-associated transmission of Panton-Valentine leucocidin positive methicillin-resistant Staphylococcus aureus: the value of screening asymptomatic healthcare workers.BMC infectious diseases · 2018Article
- Development of Antibacterial and Antifungal Triazole Chromium(III) and Cobalt(II) Complexes: Synthesis and Biological Activity Evaluations.Molecules (Basel, Switzerland) · 2018Article
- New Threats from an Old Foe: Methicillin-Resistant Staphylococcus aureus Infections in Neonates.Neonatology · 2018Review
- Preventing Transmission of Multidrug-Resistant Pathogens in the Intensive Care Unit.Infectious disease clinics of North America · 2017Review
- Bacterial Infections in Neonates Following Mupirocin-Based MRSA Decolonization: A Multicenter Cohort Study.Infection control and hospital epidemiology · 2017Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
backgroundMeticillin-resistant Staphylococcus aureus (MRSA) is a leading cause of healthcare-associated infection in the neonatal intensive care unit (NICU). Decolonization may eliminate bacterial reservoirs that drive MRSA transmission.
aimTo measure the association between colonization pressure from decolonized and non-decolonized neonates and MRSA acquisition to inform use of this strategy for control of endemic MRSA.
methodsAn eight-year retrospective cohort study was conducted in a level-4 NICU that used active surveillance cultures and decolonization for MRSA control. Weekly colonization pressure exposures were defined as the number of patient-days of concurrent admission with treated (decolonized) and untreated (non-decolonized) MRSA carriers in the preceding seven days. Poisson regression was used to estimate risk of incident MRSA colonization associated with colonization pressure exposures. The population-attributable fraction was calculated to assess the proportion of overall unit MRSA incidence attributable to treated or untreated patients in this setting.
findingsEvery person-day increase in exposure to an untreated MRSA carrier was associated with a 6% increase in MRSA acquisition risk [relative risk (RR): 1.06; 95% confidence interval (CI): 1.01-1.11]. Risk of acquisition was not influenced by exposure to treated, isolated MRSA carriers (RR: 1.01; 95% CI: 0.98-1.04). In the context of this MRSA control programme, 22% (95% CI: 4.0-37) of MRSA acquisition could be attributed to exposures to untreated MRSA carriers.
conclusionUntreated MRSA carriers were an important reservoir for transmission. Decolonized patients on contact isolation posed no detectable transmission threat, supporting the hypothesis that decolonization may reduce patient-to-patient transmission. Non-patient reservoirs may contribute to unit MRSA acquisition and require further investigation.
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