Korean J Pediatr Infect Dis.  2012 Dec;19(3):111-120.

Colonization Rate of Methicillin-resistant Staphylococcus aureus in Neonates: A Single Center Experience

• Choi SY
• Han SW
• Yoon HS
• Ki M

Abstract

PURPOSE
The aim of this study is to investigate the colonization rate of Methicillin-resistant Staphylococcus aureus (MRSA) in neonates by different clinical characteristics, to presume the origin of MRSA acquisition, and to identify the risk factors associated with MRSA colonization.
METHODS
We retrospectively reviewed the medical records of 1,733 neonates admitted to Seoul Eulji hospital Neonatal Intensive Care Unit between January 2008 and December 2011. Nasal, inguinal and rectal swab specimens were obtained upon admission and each week until discharge. We classified the route of MRSA acquisition as; hospital associated (HA-MRSA) and community associated (CA-MRSA) according to the case definition.
RESULTS
Among 1,733 neonates, 415 (23.9%) were colonized with MRSA. Gestational age, birth weight, delivery type, maternal antibiotics usage before delivery, birth place and care place before admission were influencing factors in colonization of MRSA. The colonization rate was significantly high in neonates without maternal prophylactic antibiotics use before delivery than in the other group (relative risk 2.77, 95% CI 1.88-4.07; P<0.01), and outborns showed higher MRSA colonization rate compared to inborns (relative risk 2.28, 95% CI 1.17-4.42; P=0.015).
CONCLUSION
We identified the neonatal MRSA colonization rate to be 23.9%. We estimated HA-MRSA colonization rate to be 10% (51/511) and CA-MRSA colonization rate to be 36% (309/858). We ascertained that risk factors in MRSA colonization in neonates were prophylactic use of antibiotics in mothers and the birth place.

Keyword

Staphylococcus aureus; Methicillin-resistant Staphylococcus aureus; Colonization; Newborn

MeSH Terms

Anti-Bacterial Agents
Birth Weight
Colon
Gestational Age
Humans
Hypogonadism
Infant, Newborn
Intensive Care, Neonatal
Medical Records
Methicillin Resistance
Methicillin-Resistant Staphylococcus aureus
Mitochondrial Diseases
Mothers
Ophthalmoplegia
Residence Characteristics
Retrospective Studies
Risk Factors
Staphylococcus aureus
Anti-Bacterial Agents
Hypogonadism
Mitochondrial Diseases
Ophthalmoplegia

Figure

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  Fig. 1 Kaplan-Meier estimated cumulative probability of methicillin-resistant Staphylococcus aureus colonization free staus in hospitalized neonates by birth weight group. Neonates less 1,500 g were methicillin-resistant Staphylococcus aureus non-colonizer when they were admitted. But they rapidly became methicillin-resistant Staphylococcus aureus colonizer over time. Most neonates excess 2,500 g tended to be methicillin-resistant Staphylococcus aureus colonizer when they admitted.

• 

  Fig. 2 Kaplan-Meier estimated cumulative probability of methicillin-resistant Staphylococcus aureus colonization free status in hospitalized neonates by care place group. Neonates from community had shorter hospitalized days than inborn neonates. Inborn neonates became methicillin-resistant Staphylococcus aureus colonizer over time. Community means home, private facility (Joriwon) or public facility.

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