Methicillin-resistant Staphylococcus aureus colonization and its association with infection among infants hospitalized in neonatal intensive care units

被引:138
作者
Huang, Yhu-Chering
Chou, Yi-Hong
Su, Lin-Hui
Lien, Rey-In
Lin, Tzou-Yien
机构
[1] Chang Gung Childrens Hosp, Div Pediat Infect Dis, Taoyuan, Taiwan
[2] Chang Gung Childrens Hosp, Div Neonatol, Taoyuan, Taiwan
[3] Chang Gung Mem Hosp, Dept Clin Pathol, Taoyuan, Taiwan
[4] Chang Gung Univ, Sch Med, Taoyuan, Taiwan
关键词
methicillin-resistant Staphylococcus aureus; colonization; infection; genotyping analysis; neonatal intensive care unit;
D O I
10.1542/peds.2006-0254
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
OBJECTIVES. We conducted this study to assess the rate of methicillin-resistant Staphylococcus aureus colonization and its association with infection among infants hospitalized in methicillin-resistant S aureus-endemic NICUs. METHODS. Between March 2003 and February 2004, surveillance culture specimens from the nares, postauricular areas, axillae, and umbilicus of infants admitted to the NICUs at a children's hospital in Taiwan were obtained weekly for the detection of methicillin- resistant S aureus. All colonized and clinical isolates from each study infant with methicillin- resistant S aureus infection were genotyped with pulsed-field gel electrophoresis, with Sma1 digestion, and compared. RESULTS. A total of 783 infants were included in this study. Methicillin-resistant S aureus colonization was detected for 323 infants during their NICU stays, with detection with the first 2 samples for 89%. Nares and umbilicus were the 2 most common sites of initial colonization. Methicillin-resistant S aureus colonization was associated significantly with premature birth (<= 28 weeks) and low birth weight (<= 1500 g), and infants with colonization had a significantly higher rate of methicillin-resistant S aureus infection, compared with those without colonization (26% vs 2%). Methicillin- resistant S aureus colonization was noted for 84 of 92 infants with methicillin- resistant S aureus infections. Of the 68 episodes with previous colonization and isolates available for genotyping analysis, colonized and clinical isolates were indistinguishable in 63 episodes, highly related in 2 episodes, and distinct in 3 episodes. CONCLUSIONS. More than 40% of the hospitalized infants were colonized with methicillin-resistant S aureus during their stay in methicillin- resistant S aureus - endemic NICUs; this was associated significantly with methicillin- resistant S aureus infection. Most infants with methicillin- resistant S aureus infections had previous colonization with an indistinguishable strain.
引用
收藏
页码:469 / 474
页数:6
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