An Outbreak of MRSA colonisation in a Neonatal intensive care unit: use of a case control study to investigate and control it and lessons learned

We describe the investigation and management of an MRSA outbreak on a neonatal intensive care unit (NICU) and the lessons learnt.Study designOutbreak report and case-control study.Study setting and participants: The study was conducted in a 40-cot NICU in a tertiary referral hospital and included all infants colonised/infected with gentamicin-resistant MRSA.InterventionsStandard infection control measures including segregation of infants, barrier precautions, enhanced cleaning, assessment of staff practice including hand hygiene, and increased MRSA screening of infants were implemented. Continued MRSA acquisitions led to screening of all NICU staff. A case-control study was performed to assess staff contact with colonised babies and inform the management of the outbreak.ResultsEight infants were colonised with MRSA (spa type t2068), one of whom subsequently developed an MRSA bacteraemia. MRSA colonisation was significantly associated with lower gestational age; lower birthweight and with being a twin. Three nurses were MRSA colonised but only nurse 45 was colonised with MRSA spa type t2068. Multivariable logistic regression analysis identified being cared for by nurse 45 as an independent risk factor for MRSA colonisation.InterpretationLack of accurate recording of which nurses looked after which infants (and when) made identification of the risk posed by being cared for by particular nurses difficult. If this had been clearer, it may have enabled earlier identification of th...
Source: Journal of Hospital Infection - Category: Infectious Diseases Source Type: research