Successful management of an MRSA outbreak in a neonatal intensive care unit
We report an MRSA outbreak in our 25-bed tertiary neonatal intensive care unit (NICU), which was successfully contained. Methods include a retrospective review of patient files, microbiology records and meeting protocols. During the seven months of outbreak, 27 patients and seven health care workers...
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| Veröffentlicht in: | European journal of clinical microbiology & infectious diseases 2011-07, Vol.30 (7), p.909-913 |
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| creator | Heinrich, N. Mueller, A. Bartmann, P. Simon, A. Bierbaum, G. Engelhart, S. |
| description | We report an MRSA outbreak in our 25-bed tertiary neonatal intensive care unit (NICU), which was successfully contained. Methods include a retrospective review of patient files, microbiology records and meeting protocols. During the seven months of outbreak, 27 patients and seven health care workers (HCWs) had positive cultures for MRSA. The outbreak was caused by the epidemic Rhine-Hessen strain; cultured isolates were monoclonal. After a sharp increase of the number of new MRSA-cases the installation of an outbreak management team (OMT) and implementation of comprehensive measures (extensive screening and decolonization strategy including orally applied vancomycin, isolation wards, intensive disinfection regimen) successfully terminated the outbreak within one month. Ten (53%) of 19 patients with completed follow-up and all of the HCWs were decolonized successfully. Gastrointestinal colonization was present in 15 of 27 (56%) neonates, and was associated with poor decolonization success (30% vs. 78% in absence of gastrointestinal colonization). A comprehensive outbreak management can terminate an outbreak in a NICU setting within a short time. Thorough screening of nares, throat and especially stool is necessary for correct cohorting. Gastrointestinal decolonization in neonates seems difficult. |
| doi_str_mv | 10.1007/s10096-011-1175-4 |
| format | Article |
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Methods include a retrospective review of patient files, microbiology records and meeting protocols. During the seven months of outbreak, 27 patients and seven health care workers (HCWs) had positive cultures for MRSA. The outbreak was caused by the epidemic Rhine-Hessen strain; cultured isolates were monoclonal. After a sharp increase of the number of new MRSA-cases the installation of an outbreak management team (OMT) and implementation of comprehensive measures (extensive screening and decolonization strategy including orally applied vancomycin, isolation wards, intensive disinfection regimen) successfully terminated the outbreak within one month. Ten (53%) of 19 patients with completed follow-up and all of the HCWs were decolonized successfully. Gastrointestinal colonization was present in 15 of 27 (56%) neonates, and was associated with poor decolonization success (30% vs. 78% in absence of gastrointestinal colonization). A comprehensive outbreak management can terminate an outbreak in a NICU setting within a short time. Thorough screening of nares, throat and especially stool is necessary for correct cohorting. Gastrointestinal decolonization in neonates seems difficult.</description><identifier>ISSN: 0934-9723</identifier><identifier>EISSN: 1435-4373</identifier><identifier>DOI: 10.1007/s10096-011-1175-4</identifier><identifier>PMID: 21298461</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Bacterial Typing Techniques ; Biological and medical sciences ; Biomedical and Life Sciences ; Biomedicine ; Colonization ; Cross Infection - epidemiology ; Cross Infection - microbiology ; Decolonization ; Disease Outbreaks ; Epidemics ; Hospitals ; Human health and pathology ; Humans ; Hygiene ; Immunology ; Infant ; Infant, Newborn ; Infection Control - methods ; Infectious diseases ; Intensive care ; Intensive Care, Neonatal ; Internal Medicine ; Laboratories ; Life Sciences ; Medical Microbiology ; Medical personnel ; Medical sciences ; Methicillin-Resistant Staphylococcus aureus - classification ; Methicillin-Resistant Staphylococcus aureus - genetics ; Methicillin-Resistant Staphylococcus aureus - isolation & purification ; Microbiology ; Neonatal care ; Neonates ; Outbreaks ; Parasitology ; Patients ; Staphylococcal Infections - epidemiology ; Staphylococcal Infections - microbiology ; Staphylococcus infections</subject><ispartof>European journal of clinical microbiology & infectious diseases, 2011-07, Vol.30 (7), p.909-913</ispartof><rights>Springer-Verlag 2011</rights><rights>2015 INIST-CNRS</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c477t-a7eefb64901d0e79eace9cae1352cb1c2f8a1d7c178b71aebbeb4f46d0cb8d663</citedby><cites>FETCH-LOGICAL-c477t-a7eefb64901d0e79eace9cae1352cb1c2f8a1d7c178b71aebbeb4f46d0cb8d663</cites><orcidid>0000-0003-4641-6186</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10096-011-1175-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10096-011-1175-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,780,784,885,27922,27923,41486,42555,51317</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24275369$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21298461$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.science/hal-00666671$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Heinrich, N.</creatorcontrib><creatorcontrib>Mueller, A.</creatorcontrib><creatorcontrib>Bartmann, P.</creatorcontrib><creatorcontrib>Simon, A.</creatorcontrib><creatorcontrib>Bierbaum, G.</creatorcontrib><creatorcontrib>Engelhart, S.</creatorcontrib><title>Successful management of an MRSA outbreak in a neonatal intensive care unit</title><title>European journal of clinical microbiology & infectious diseases</title><addtitle>Eur J Clin Microbiol Infect Dis</addtitle><addtitle>Eur J Clin Microbiol Infect Dis</addtitle><description>We report an MRSA outbreak in our 25-bed tertiary neonatal intensive care unit (NICU), which was successfully contained. Methods include a retrospective review of patient files, microbiology records and meeting protocols. During the seven months of outbreak, 27 patients and seven health care workers (HCWs) had positive cultures for MRSA. The outbreak was caused by the epidemic Rhine-Hessen strain; cultured isolates were monoclonal. After a sharp increase of the number of new MRSA-cases the installation of an outbreak management team (OMT) and implementation of comprehensive measures (extensive screening and decolonization strategy including orally applied vancomycin, isolation wards, intensive disinfection regimen) successfully terminated the outbreak within one month. Ten (53%) of 19 patients with completed follow-up and all of the HCWs were decolonized successfully. Gastrointestinal colonization was present in 15 of 27 (56%) neonates, and was associated with poor decolonization success (30% vs. 78% in absence of gastrointestinal colonization). A comprehensive outbreak management can terminate an outbreak in a NICU setting within a short time. Thorough screening of nares, throat and especially stool is necessary for correct cohorting. Gastrointestinal decolonization in neonates seems difficult.</description><subject>Bacterial Typing Techniques</subject><subject>Biological and medical sciences</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Colonization</subject><subject>Cross Infection - epidemiology</subject><subject>Cross Infection - microbiology</subject><subject>Decolonization</subject><subject>Disease Outbreaks</subject><subject>Epidemics</subject><subject>Hospitals</subject><subject>Human health and pathology</subject><subject>Humans</subject><subject>Hygiene</subject><subject>Immunology</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Infection Control - methods</subject><subject>Infectious diseases</subject><subject>Intensive care</subject><subject>Intensive Care, Neonatal</subject><subject>Internal Medicine</subject><subject>Laboratories</subject><subject>Life Sciences</subject><subject>Medical Microbiology</subject><subject>Medical personnel</subject><subject>Medical sciences</subject><subject>Methicillin-Resistant Staphylococcus aureus - 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epidemiology</topic><topic>Cross Infection - microbiology</topic><topic>Decolonization</topic><topic>Disease Outbreaks</topic><topic>Epidemics</topic><topic>Hospitals</topic><topic>Human health and pathology</topic><topic>Humans</topic><topic>Hygiene</topic><topic>Immunology</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Infection Control - methods</topic><topic>Infectious diseases</topic><topic>Intensive care</topic><topic>Intensive Care, Neonatal</topic><topic>Internal Medicine</topic><topic>Laboratories</topic><topic>Life Sciences</topic><topic>Medical Microbiology</topic><topic>Medical personnel</topic><topic>Medical sciences</topic><topic>Methicillin-Resistant Staphylococcus aureus - classification</topic><topic>Methicillin-Resistant Staphylococcus aureus - genetics</topic><topic>Methicillin-Resistant Staphylococcus aureus - isolation & purification</topic><topic>Microbiology</topic><topic>Neonatal care</topic><topic>Neonates</topic><topic>Outbreaks</topic><topic>Parasitology</topic><topic>Patients</topic><topic>Staphylococcal Infections - 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Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><collection>Hyper Article en Ligne (HAL) (Open Access)</collection><jtitle>European journal of clinical microbiology & infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Heinrich, N.</au><au>Mueller, A.</au><au>Bartmann, P.</au><au>Simon, A.</au><au>Bierbaum, G.</au><au>Engelhart, S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Successful management of an MRSA outbreak in a neonatal intensive care unit</atitle><jtitle>European journal of clinical microbiology & infectious diseases</jtitle><stitle>Eur J Clin Microbiol Infect Dis</stitle><addtitle>Eur J Clin Microbiol Infect Dis</addtitle><date>2011-07-01</date><risdate>2011</risdate><volume>30</volume><issue>7</issue><spage>909</spage><epage>913</epage><pages>909-913</pages><issn>0934-9723</issn><eissn>1435-4373</eissn><abstract>We report an MRSA outbreak in our 25-bed tertiary neonatal intensive care unit (NICU), which was successfully contained. Methods include a retrospective review of patient files, microbiology records and meeting protocols. During the seven months of outbreak, 27 patients and seven health care workers (HCWs) had positive cultures for MRSA. The outbreak was caused by the epidemic Rhine-Hessen strain; cultured isolates were monoclonal. After a sharp increase of the number of new MRSA-cases the installation of an outbreak management team (OMT) and implementation of comprehensive measures (extensive screening and decolonization strategy including orally applied vancomycin, isolation wards, intensive disinfection regimen) successfully terminated the outbreak within one month. Ten (53%) of 19 patients with completed follow-up and all of the HCWs were decolonized successfully. Gastrointestinal colonization was present in 15 of 27 (56%) neonates, and was associated with poor decolonization success (30% vs. 78% in absence of gastrointestinal colonization). A comprehensive outbreak management can terminate an outbreak in a NICU setting within a short time. Thorough screening of nares, throat and especially stool is necessary for correct cohorting. Gastrointestinal decolonization in neonates seems difficult.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>21298461</pmid><doi>10.1007/s10096-011-1175-4</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0003-4641-6186</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Bacterial Typing Techniques Biological and medical sciences Biomedical and Life Sciences Biomedicine Colonization Cross Infection - epidemiology Cross Infection - microbiology Decolonization Disease Outbreaks Epidemics Hospitals Human health and pathology Humans Hygiene Immunology Infant Infant, Newborn Infection Control - methods Infectious diseases Intensive care Intensive Care, Neonatal Internal Medicine Laboratories Life Sciences Medical Microbiology Medical personnel Medical sciences Methicillin-Resistant Staphylococcus aureus - classification Methicillin-Resistant Staphylococcus aureus - genetics Methicillin-Resistant Staphylococcus aureus - isolation & purification Microbiology Neonatal care Neonates Outbreaks Parasitology Patients Staphylococcal Infections - epidemiology Staphylococcal Infections - microbiology Staphylococcus infections |
| title | Successful management of an MRSA outbreak in a neonatal intensive care unit |
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