Korean J Perinatol.  2010 Sep;21(3):248-257.

The Effect of Eradication of Methicillin-resistant Staphylococcus aureus from Neonatal Intensive Care unit by Aggressive Infection Control Measures : Isolation Program and the Use of Chlorhexidine

• Kim HJ
• Kang SJ
• Park HK
• Kim CR
• Choi TY
• Oh SH

Abstract

PURPOSE
The increasing incidence and mortality of Methicillin-resistant Staphylococcus aureus (MRSA) colonization or blood-stream infection is an important problem in neonatal intensive care unit (NICU). The aims of this study are to evaluate the effective eradication of MRSA through the aggressive isolation program with or without the use of 2% chlorhexidine-gluconate (CHG) and to investigate significant risk factors of MRSA colonization in NICU.
METHODS
This study is a retrospective collected data among 414 neonates admitted to a NICU from June 1, 2007, through October 31, 2009. We divided the groups into 3 periods according to isolation program or the use of 2% CHG.
RESULTS
The aggressive isolation program decreased the incidence of MRSA colonization and the additional use of 2% CHG has reduced much more the incidence of MRSA colonization and bacteremia. Days of hospitalization, use of central line, days of using central line, presence of respiratory distress syndrome (RDS) or bronchopulmonary dysplasia (BPD), isolation program, and isolation program + use of CHG were significant factors associated with MRSA colonization or bacteremia in univariate logistic regression analysis. Days of using central line and isolation program + use of CHG were significant after in multivariate logistic regression analysis.
CONCLUSION
Hand hygiene, active MRSA surveillance culture, isolation, contact isolation, nursing/doctor cohorts and the use of 2% CHG as skin sterilizer were effective in eradicating to MRSA. The effort of shortening the days of using central line is also necessary.

Keyword

MRSA; Isolation program; Chlorhexidine; Neonatal intensive care unit

MeSH Terms

Bacteremia
Bronchopulmonary Dysplasia
Chlorhexidine
Cohort Studies
Colon
Hand Hygiene
Hospitalization
Humans
Incidence
Infant, Newborn
Infection Control
Intensive Care, Neonatal
Logistic Models
Methicillin Resistance
Methicillin-Resistant Staphylococcus aureus
Retrospective Studies
Risk Factors
Skin
Chlorhexidine