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Nguyen TQN, Le DQ, Hoang TMH, Tran DX. Staphylococcus aureus pneumonia in neonates: clinical patterns, laboratory findings and outcomes. Pediatr Neonatol 2025:S1875-9572(25)00081-6. [PMID: 40280778 DOI: 10.1016/j.pedneo.2025.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2024] [Revised: 02/12/2025] [Accepted: 03/03/2025] [Indexed: 04/29/2025] Open
Abstract
BACKGROUND Staphylococcus aureus (SA) pneumonia is a leading cause of neonatal morbidity and mortality, particularly with methicillin-resistant Staphylococcus aureus (MRSA). Despite its prevalence, limited studies have focused on clinical presentation, antimicrobial resistance patterns, and outcomes of SA pneumonia in neonates. This study aimed to explore the clinical features, laboratory findings, and outcomes of neonates with SA pneumonia at the National Children's Hospital, Vietnam. METHODS We conducted a retrospective observational study on 31 neonates diagnosed with SA pneumonia from January 2022 to June 2023. Clinical data, including demographic details, symptoms, white blood cell (WBC) count, C-reactive protein (CRP) levels, antimicrobial susceptibility, and radiological findings, were collected. We analyzed the antibiotic resistance patterns of SA and evaluated factors associated with vancomycin treatment failure. RESULTS Of the 31 neonates, 96.8 % were diagnosed with MRSA pneumonia. The main clinical symptoms were fever (77.4 %), tachypnea (83.9 %), and chest retraction (80.6 %). SA was primarily isolated from endotracheal fluid (71.0 %), pleural fluid (41.9 %), and both combined (51.6 %) with positive blood cultures. Complications were common, with pleural effusion in 54.8 %, pneumothorax in 48.4 %, necrotizing pneumonia in 25.8 %, and lung abscess in 29.0 % of cases. Vancomycin was the primary antibiotic administered, though treatment failure occurred in 38.7 % of cases, necessitating alternative antibiotics, particularly in patients with severe illness requiring mechanical ventilation, vasopressor support, and elevated CRP levels (>15 mg/L). Most strains were resistant to beta-lactam antibiotics but sensitive to vancomycin, linezolid, ciprofloxacin, and levofloxacin. The average hospital stay was 24.4 ± 12.6 days, with a mortality rate of 12.9 %, mainly due to severe respiratory failure and septic shock. CONCLUSION These findings highlight the critical importance of early diagnosis, optimized antibiotic therapy, and careful monitoring to reduce complications and improve survival outcomes in neonates with SA pneumonia.
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Affiliation(s)
- Thi Quynh Nga Nguyen
- Department of Pediatrics, Hanoi Medical University, Viet Nam; Neonatal Center, Vietnam National Children's Hospital, Viet Nam.
| | - Duc Quang Le
- Department of Pediatrics, Hanoi Medical University, Viet Nam
| | | | - Dang Xoay Tran
- Pediatric Intensive Care Unit, Vietnam National Children's Hospital, Viet Nam
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Jennings MR, Elhaissouni N, Colantuoni E, Prochaska EC, Johnson J, Xiao S, Clark RH, Greenberg RG, Benjamin DK, Milstone AM. Epidemiology and Mortality of Invasive Staphylococcus aureus Infections in Hospitalized Infants. JAMA Pediatr 2025:2832660. [PMID: 40227743 PMCID: PMC11997858 DOI: 10.1001/jamapediatrics.2025.0429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2024] [Accepted: 01/08/2025] [Indexed: 04/15/2025]
Abstract
Importance Historically, Staphylococcus aureus has been a leading cause of morbidity and mortality in the neonatal intensive care unit (NICU). The current incidence and attributable mortality of late-onset invasive S aureus infection in hospitalized infants is unknown. Objective To estimate the incidence and attributable mortality of late-onset S aureus infection among hospitalized infants in the US. Design, Setting, and Participants This retrospective cohort study included an emulated trial among a national convenience sample of 315 NICUs within the US between 2016 and 2021. Participants were infants aged at least 4 postnatal days who were hospitalized in a participating NICU. Data were analyzed from May to August 2024. Exposures The primary exposures were birth weight and postnatal age. Main Outcomes and Measures The outcomes were the incidence and attributable mortality of late-onset invasive S aureus infection. Methicillin-resistant and methicillin-sensitive S aureus classification was not universally available; thus, all invasive S aureus infections were pooled. Results From 468 201 infants (260 491 [55.6%] male; median [IQR] gestational age, 36 [33-38] weeks) eligible for analysis, 1724 infants experienced 1762 infections for an overall incidence of 37.6 (95% CI, 35.9-39.4) invasive S aureus infections per 10 000 infants. Most infants with invasive infections were 32 weeks' gestational age or younger (1394 infants [80.9%]), very low birth weight (VLBW; ie, <1500 g) (1318 infants [76.5%]), and/or had a central line during their hospital stay (1509 infants [87.5%]). Invasive infections mostly included bloodstream infections (1505 infections [85.4%]), and 1160 infections (65.8%) occurred within 4 to 28 postnatal days. Birth weight inversely correlated with incidence: infants with VLBW experienced a more than 20-fold higher incidence relative to infants born weighing at least 1500 g (227.1 [95% CI, 215.3-239.4] vs 10.1 [95% CI, 9.1-11.1] infections per 10 000 infants). Most deaths following invasive infection occurred among VLBW infants (189 of 209 deaths [90.4%]). Compared with matched infants without a late-onset invasive S aureus infection, infected infants had an absolute difference in mortality rate of 5.3% (95% CI, 3.8%-6.8%). Conclusions and Relevance This cohort study found late-onset invasive S aureus infection and subsequent attributable mortality disproportionally affected infants with VLBW. Targeted infection prevention and control measures are necessary to reduce morbidity and mortality from invasive S aureus infections in this vulnerable population.
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Affiliation(s)
- Maria Rain Jennings
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Nora Elhaissouni
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Elizabeth Colantuoni
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Erica C. Prochaska
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Hospital Epidemiology and Infection Control, Johns Hopkins Hospital, Baltimore, Maryland
| | - Julia Johnson
- Division of Neonatology, Department of Pediatrics, Johns Hopkins University School of Medicine, Maryland
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Shaoming Xiao
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | - Rachel G. Greenberg
- Department of Pediatrics Duke University School of Medicine, Durham, North Carolina
- Duke Clinical Research Institute, Durham, North Carolina
| | - Daniel K. Benjamin
- Department of Pediatrics Duke University School of Medicine, Durham, North Carolina
- Duke Clinical Research Institute, Durham, North Carolina
| | - Aaron M. Milstone
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Hospital Epidemiology and Infection Control, Johns Hopkins Hospital, Baltimore, Maryland
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Ishikawa K, Tsuchida T, Ichiki K, Ueda T, Yamada K, Iijima K, Otani N, Nakajima K. Efficacy of Enhanced Environmental Cleaning/Disinfection Using Pulsed Xenon Ultraviolet Light in Preventing Outbreaks of Methicillin-Resistant Staphylococcus aureus in Neonatal Intensive Care Units. EPIDEMIOLOGIA 2025; 6:12. [PMID: 40137000 PMCID: PMC11941118 DOI: 10.3390/epidemiologia6010012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2024] [Revised: 02/27/2025] [Accepted: 02/28/2025] [Indexed: 03/27/2025] Open
Abstract
BACKGROUND/OBJECTIVES In recent years, non-contact room disinfection devices using ultraviolet light and hydrogen peroxide have emerged as disinfection methods. However, data on their usefulness in neonatal intensive care units (NICUs) are limited. Therefore, the aim of the present study was to evaluate the effectiveness of environmental disinfection in controlling methicillin-resistant Staphylococcus aureus (MRSA) outbreaks in a NICU/growing care unit (GCU). METHODS Daily cleaning/disinfection of the patient environment was changed from using a cloth containing quaternary ammonium salts to an agent containing ethanol and surfactant, and terminal cleaning with a pulsed xenon ultraviolet light (PX-UV) non-contact disinfection device was added for patients with confirmed MRSA and those on contact precautions. MRSA incidence and environmental culture results were then compared before and after the method change. RESULTS The MRSA infection rate was 2.81/1000 patient days before the method change and 0.90/1000 patient days after the change (p = 0.008). Environmental cultures were positive in 12/137 (8.8%) before the change and 0 after the change. There were no adverse events in the neonates due to PX-UV irradiation of the environment. CONCLUSIONS Daily cleaning and disinfection with ethanol and surfactant-containing cleaning disinfectants and a final cleaning with a PX-UV non-contact disinfection device reduced environmental MRSA contamination. In addition to adherence to hand hygiene and contact precautions, reducing MRSA present in the environment may contribute to MRSA control in NICUs and GCUs.
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Affiliation(s)
- Kaori Ishikawa
- Department of Infection Control and Prevention, Hyogo Medical University Hospital, Nishinomiya 663-8501, Japan; (T.T.); (T.U.)
| | - Toshie Tsuchida
- Department of Infection Control and Prevention, Hyogo Medical University Hospital, Nishinomiya 663-8501, Japan; (T.T.); (T.U.)
- School of Nursing, Hyogo Medical University, Kobe 650-8530, Japan
| | - Kaoru Ichiki
- Department of Infection Control and Prevention, Hyogo Medical University Hospital, Nishinomiya 663-8501, Japan; (T.T.); (T.U.)
| | - Takashi Ueda
- Department of Infection Control and Prevention, Hyogo Medical University Hospital, Nishinomiya 663-8501, Japan; (T.T.); (T.U.)
| | - Kumiko Yamada
- Department of Infection Control and Prevention, Hyogo Medical University Hospital, Nishinomiya 663-8501, Japan; (T.T.); (T.U.)
- Department of Laboratory Technology, Hyogo Medical University Hospital, Nishinomiya 663-8501, Japan
| | - Kosuke Iijima
- Department of Laboratory Technology, Hyogo Medical University Hospital, Nishinomiya 663-8501, Japan
| | - Naruhito Otani
- Department of Infection Control and Prevention, Hyogo Medical University Hospital, Nishinomiya 663-8501, Japan; (T.T.); (T.U.)
| | - Kazuhiko Nakajima
- Department of Infection Control and Prevention, Hyogo Medical University Hospital, Nishinomiya 663-8501, Japan; (T.T.); (T.U.)
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Du Y, Xiu N. Exonuclease-III Assisted the Target Recycling Coupling with Hybridization Chain Reaction for Sensitive mecA Gene Analysis by Using PGM. Appl Biochem Biotechnol 2024; 196:6716-6725. [PMID: 38401042 DOI: 10.1007/s12010-024-04862-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2024] [Indexed: 02/26/2024]
Abstract
In the field of neonatal infections nursing, methicillin-resistant Staphylococcus aureus (MRSA) is a major bacterial pathogen. Here, we present a portable biosensor for MRSA detection that is both highly sensitive and portable, owing to its implementation on the personal glucose meter (PGM) platform. The H probe was fixed on the magnetic bead for mecA gene analysis. A blunt 3' terminus appeared in the MBs-H probe when the mecA gene was present. Exonuclease-III (Exo-III) recognized the blunt terminus and cleaved it, freeing the mecA gene and so facilitating target recycling. In the meantime, the remaining H probe-initiated hybridization chain reaction (HCR) led to the desired signal amplification. Portable quantitative detection of mecA gene is possible because PGM can read the quantity of invertase tagged on HCR product. After optimizing several experimental parameters, such as the concentration of Exo-III and incubation time, the constructed sensor is extremely sensitive, with a detection limit of 2 CFU/mL. The results from this sensitive PGM-based sensor are in agreement with those obtained from plate counting methods, suggesting that it can be used to accurately assess the MRSA content in artificial clinical samples. In addition, the PGM sensor can significantly cut down on time spent compared to plate counting techniques. The manufactured sensor provides a promising option for accurate identification of pathogenic bacteria.
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Affiliation(s)
- Yan Du
- Department of Neonatology, The First Hospital of China Medical University, Shenyang City, Liaoning Province, 110000, China
| | - Ning Xiu
- Department of Neonatology, The First Hospital of China Medical University, Shenyang City, Liaoning Province, 110000, China.
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Gutierrez-Tobar I, Carvajal C, Vasquez-Hoyos P, Díaz-Díaz A, Londono Ruiz JP, Andrade J, Camacho-Cruz J, Restrepo-Gouzy A, Trujillo-Honeysberg M, Mesa-Monsalve JG, Perez I, Von Moltke R, Beltran-Echeverry M, Toro JF, Niño AP, Camacho-Moreno G, Calle-Giraldo JP, Cabeza NY, Sandoval-Calle LM, Perez Camacho P, Patiño Niño J, Araque-Muñoz P, Rodríguez-Peña Y, Beltran-Arroyave C, Chaucanez-Bastidas Y, Lopez J, Galvis-Trujillo D, Beltrán-Higuera S, Marino AC, González Leal N, Luengas Monroy MÁ, Hernandez-Moreno DC, Vivas Trochez R, Garces C, López-Medina E. Epidemiological and microbiological characteristics of S. aureus pediatric infections in Colombia 2018-2021, a national multicenter study (Staphylored Colombia). Front Pediatr 2024; 12:1386310. [PMID: 38895192 PMCID: PMC11183781 DOI: 10.3389/fped.2024.1386310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 05/13/2024] [Indexed: 06/21/2024] Open
Abstract
Background Staphylococcus aureus infections are a significant cause of morbidity and mortality in pediatric populations worldwide. The Staphylo Research Network conducted an extensive study on pediatric patients across Colombia from 2018 to 2021. The aim of this study was to describe the epidemiological and microbiological characteristics of S. aureus in this patient group. Methods We analyzed S. aureus isolates from WHONET-reporting centers. An "event" was a positive culture isolation in a previously negative individual after 2 weeks. We studied center characteristics, age distribution, infection type, and antibiotic susceptibilities, comparing methicillin sensitive (MSSA) and resistant S. aureus (MRSA) isolates. Results Isolates from 20 centers across 7 Colombian cities were included. Most centers (80%) served both adults and children, with 55% offering oncology services and 85% having a PICU. We registered 8,157 S. aureus culture isolations from 5,384 events (3,345 MSSA and 1,961 MRSA) in 4,821 patients, with a median age of 5 years. Blood (26.2%) and skin/soft tissue (18.6%) were the most common infection sources. Most isolates per event remained susceptible to oxacillin (63.2%), clindamycin (94.3%), and TMP-SMX (98.3%). MRSA prevalence varied by city (<0.001), with slightly higher rates observed in exclusively pediatric hospitals. In contrast, the MRSA rate was somewhat lower in centers with Antimicrobial Stewardship Program (ASP). MRSA was predominantly isolated from osteoarticular infections and multiple foci, while MSSA was more frequently associated with recurrent infections compared to MRSA. Conclusions This is the largest study of pediatric S. aureus infections in Colombia. We found MSSA predominance, but resistance have important regional variations. S. aureus remains susceptible to other commonly used antibiotics such as TMP-SMX and clindamycin. Ongoing monitoring of S. aureus infections is vital for understanding their behavior in children. Prospective studies within the Staphylored LATAM are underway for a more comprehensive clinical and genetic characterization.
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Affiliation(s)
- Ivan Gutierrez-Tobar
- Department of Pediatrics, Clínica Infantil Santa Maria Del Lago, Bogotá, Colombia
- Department of Pediatrics, Clinica Infantil Colsubsidio, Bogotá, Colombia
- Staphylored LATAM, Bogotá, Colombia
| | - Cristobal Carvajal
- Staphylored LATAM, Bogotá, Colombia
- Universidad Finis Terrae, Santiago, Chile
| | - Pablo Vasquez-Hoyos
- Staphylored LATAM, Bogotá, Colombia
- Department of Pediatrics, Fundacion Universitaria de Ciencias de la Salud (FUCS), Bogotá, Colombia
- Universidad Nacional de Colombia, Bogotá, Colombia
- Sociedad de Cirugía de Bogotá Hospital de San Jose, Bogotá, Colombia
| | - Alejandro Díaz-Díaz
- Staphylored LATAM, Bogotá, Colombia
- Department of Pediatrics, Hospital Pablo Tobon Uribe, Medellín, Colombia
- Department of Pediatrics, Hospital General de Medellín, Medellín, Colombia
| | - Juan Pablo Londono Ruiz
- Department of Pediatrics, Clinica Infantil Colsubsidio, Bogotá, Colombia
- Staphylored LATAM, Bogotá, Colombia
| | - Joam Andrade
- Staphylored LATAM, Bogotá, Colombia
- Department of Pediatrics, Hospital Militar Central, Bogotá, Colombia
| | - Jhon Camacho-Cruz
- Staphylored LATAM, Bogotá, Colombia
- Department of Pediatrics, Fundacion Universitaria de Ciencias de la Salud (FUCS), Bogotá, Colombia
- Universidad Nacional de Colombia, Bogotá, Colombia
- Sociedad de Cirugía de Bogotá Hospital de San Jose, Bogotá, Colombia
- Department of Pediatrics, Fundación Universitaria Sanitas, Bogotá, Colombia
- Department of Pediatrics, Clínica Reina Sofia Pediátrica y Mujer, Bogotá, Colombia
| | | | | | | | | | - Richard Von Moltke
- Staphylored LATAM, Bogotá, Colombia
- Universidad Finis Terrae, Santiago, Chile
| | - Maria Beltran-Echeverry
- Department of Pediatrics, Clínica Infantil Santa Maria Del Lago, Bogotá, Colombia
- Staphylored LATAM, Bogotá, Colombia
- Sociedad de Cirugía de Bogotá Hospital de San Jose, Bogotá, Colombia
| | - Jessica F. Toro
- Department of Pediatrics, Clínica Medilaser, Neiva, Colombia
| | - Angela P. Niño
- Department of Pediatrics, Clínica Medilaser, Neiva, Colombia
| | - Germán Camacho-Moreno
- Department of Pediatrics, Fundación Hospital de La Misericordia, Bogotá, Colombia
- Department of Pediatrics, Hospital Universitario Infantil de San José, Bogotá, Colombia
| | - Juan Pablo Calle-Giraldo
- Department of Pediatrics, Hospital San Juan de Dios, Armenia, Colombia
- Department of Pediatrics, Clinica Farallones, Cali, Colombia
- Department of Pediatrics, Clinica Versalles, Cali, Colombia
| | | | | | | | | | - Paula Araque-Muñoz
- Department of Pediatrics, Clinica Country, Bogotá, Colombia
- Department of Pediatrics, Clinica La Colina, Bogotá, Colombia
| | - Yazmin Rodríguez-Peña
- Department of Pediatrics, Clinica Country, Bogotá, Colombia
- Department of Pediatrics, Clinica La Colina, Bogotá, Colombia
| | | | | | - Juan Lopez
- Department of Pediatrics, Fundación Hospital de La Misericordia, Bogotá, Colombia
| | | | - Sandra Beltrán-Higuera
- Clinica Colsanitas, Bogotá, Colombia
- Department of Pediatrics, Clinica infantil Colsanitas, Bogotá, Colombia
| | | | | | | | | | - Rosalba Vivas Trochez
- Department of Pediatrics, Clínica Soma, Medellín, Colombia
- Department of Pediatrics, Hospital Universitario de San Vicente Fundación, Medellín, Colombia
| | - Carlos Garces
- Department of Pediatrics, Clinica Cardiovid Medellín, Medellin, Colombia
| | - Eduardo López-Medina
- Centro de Estudios en Infectología Pediátrica, Cali, Colombia
- Universidad del Valle, Cali, Colombia
- Department of Pediatrics, Clínica Imbanaco, Cali, Colombia
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Oldendorff F, Nordberg V, Giske CG, Navér L. A decade of neonatal sepsis in Stockholm, Sweden: Gram-positive pathogens were four times as common as Gram-negatives. Eur J Clin Microbiol Infect Dis 2024; 43:959-968. [PMID: 38517573 PMCID: PMC11108929 DOI: 10.1007/s10096-024-04809-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 03/11/2024] [Indexed: 03/24/2024]
Abstract
PURPOSE To assess Gram-positive bacterial (GPB) bloodstream infection (BSI) in neonates, covering incidence, morbidity, mortality, antimicrobial resistance patterns and biomarkers in Region Stockholm, Sweden between 2006 and 2016. METHODS A population-based retrospective epidemiological study including infants with GPB-BSI, admitted to the neonatal units at Karolinska University Hospital (KUH). Data were collected from patient records, the Swedish Neonatal Quality Register, the microbiological laboratory at KUH and the Swedish Public Health Agency. RESULTS We identified 357 infants with GPB-BSI, representing an incidence of 1.47/1000 live births (LB). Group B streptococcus (GBS) was the most common pathogen causing BSI in full-term infants and early-onset sepsis (EOS) (0.20/1000 LB), while coagulase-negative staphylococci (CoNS) were predominant in infants born very preterm and in late-onset sepsis (LOS) (0.79/1000 LB). There were no fatal GBS BSI cases, but 10.2% developed meningitis. The GPB case fatality rate was 9.5% and the sepsis fatality rate 2.8%. In GPB-BSI, 1/10 did not have an elevated C-reactive protein level. Staphylococcus aureus (S. aureus) BSI increased during the study period, but no methicillin or vancomycin resistant strains were found. The antimicrobial resistance (AMR) rate was highest in CoNS isolates. CONCLUSION GPB-BSI was four times more common than Gram-negative BSI in neonates but resulted in lower mortality rate. GBS was the most common pathogen in full-term infants and in EOS. CoNS was the most common pathogen in LOS and infants born very preterm, and the AMR rate was high in these isolates. The increasing trend of S. aureus BSI indicates a need of further investigation.
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Affiliation(s)
- Frida Oldendorff
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.
- Department of Clinical Science Intervention and Technology (CLINTEC), Division of Pediatrics, Karolinska Institutet, Stockholm, Sweden.
| | - Viveka Nordberg
- Department of Neonatology, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
- Department of Clinical Science Intervention and Technology (CLINTEC), Division of Pediatrics, Karolinska Institutet, Stockholm, Sweden
| | - Christian G Giske
- Department of Laboratory Medicine, Division of Clinical Microbiology, Karolinska Institutet, Stockholm, Sweden
- Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
| | - Lars Navér
- Department of Neonatology, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
- Department of Clinical Science Intervention and Technology (CLINTEC), Division of Pediatrics, Karolinska Institutet, Stockholm, Sweden
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Mahieu L, Engelen A, Hensels E, Van Damme K, Matheeussen V. Surveillance on meticillin-sensitive Staphylococcus aureus colonization and infection in a neonatal intensive care unit. J Hosp Infect 2024; 143:195-202. [PMID: 37858807 DOI: 10.1016/j.jhin.2023.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 10/02/2023] [Accepted: 10/10/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND Meticillin-sensitive Staphylococcus aureus (MSSA) infection is a significant health concern in neonatal intensive care units (NICUs). Bacterial colonization increases the risk of subsequent infection, leading to morbidity and mortality. AIM To report the findings of a retrospective cohort study on the surveillance of MSSA colonization and infection in NICU patients. METHODS The weekly microbial surveillance results for MSSA colonization in the throat, nose, anus, and groin, as well as invasive and non-invasive MSSA infections, were analysed from November 2020 to June 2022. The MSSA infection and colonization risk were compared after adjustment for confounders by stepwise logistic regression analysis. FINDINGS Three hundred and eighty-three neonates were screened; 42.8% (N=164) were MSSA colonized. Significant risk factors for MSSA colonization were length of stay, vaginal delivery and extreme low gestational age <28 weeks (ELGAN) (all P<0.05). The surveillance detected 38 (9.9%) mild MSSA infections and 11 (2.9%) invasive MSSA infections. Neonatal colonization with MSSA is a major risk factor for MSSA infection overall (29.3% in colonized/infected vs 70.7% colonized/not-infected and 0.5% in not-colonized/infected vs 99.5% in not-colonized/not-infected infants) and invasive MSSA infections (6.1% in colonized/infected vs 93.9% in colonized/not-infected and 0.5% in non-colonized/infected vs 99.5% not-colonized/not-infected infants). Also, extreme low birth weight (<1000 g), ELGAN and invasive ventilation were significant risk factors for MSSA infections (all, P<0.05). CONCLUSIONS The link between postnatal MSSA colonization and subsequent MSSA infection offers possibilities for prevention. Additional research is needed to explore the association between vaginal birth and the pathogenesis of neonatal MSSA colonization.
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Affiliation(s)
- L Mahieu
- Department of Neonatal Intensive Care, Antwerp University Hospital, Edegem, Belgium; Laboratory of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
| | - A Engelen
- Department of Neonatal Intensive Care, Antwerp University Hospital, Edegem, Belgium
| | - E Hensels
- Department of Neonatal Intensive Care, Antwerp University Hospital, Edegem, Belgium
| | - K Van Damme
- Department of Neonatal Intensive Care, Antwerp University Hospital, Edegem, Belgium
| | - V Matheeussen
- Department of Clinical Microbiology, Antwerp University Hospital, Edegem, Belgium
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