Risk Factors for Staphylococcus aureus Acquisition in the Neonatal Intensive Care Unit: A Matched Case-Case-Control Study. (21st November 2017)

• Record Type: Journal Article
• Authors: Washam, Matthew C.; Ankrum, Andrea; Haberman, Beth E.; Staat, Mary Allen; Haslam, David B.
• Is Part Of: Infection control and hospital epidemiology. Volume 39:Number 1(2018)
• Page Start: 46
• Page End: 52
• Publication Date: 2017-11-21
• Subjects: Nosocomial infections -- Epidemiology -- Periodicals; Health facilities -- Sanitation -- Periodicals; Hospital buildings -- Sanitation -- Periodicals; Cross Infection -- Periodicals; Epidemiology -- Periodicals; Hospitals -- Periodicals; Infection Control -- Periodicals; 614.44
• DOI: 10.1017/ice.2017.234
• Languages: English
• ISSNs: 0899-823X

Abstract

Abstract : OBJECTIVE: To determine risk factors independent of length of stay (LOS) for Staphylococcus aureus acquisition in infants admitted to the neonatal intensive care unit (NICU). DESIGN: Retrospective matched case–case-control study. SETTING: Quaternary-care referral NICU at a large academic children's hospital. METHODS: Infants admitted between January 2014 and March 2016 at a level IV NICU who acquired methicillin resistant (MRSA) or susceptible (MSSA) S. aureus were matched with controls by duration of exposure to determine risk factors for acquisition. A secondary post hoc analysis was performed on the entire cohort of at-risk infants for risk factors identified in the primary analysis to further quantify risk. RESULTS: In total, 1, 751 infants were admitted during the study period with 199 infants identified as having S. aureus prevalent on admission. There were 246 incident S. aureus acquisitions in the remaining at-risk infant cohort. On matched analysis, infants housed in a single-bed unit were associated with a significantly decreased risk of both MRSA ( P =.03) and MSSA ( P =.01) acquisition compared with infants housed in multibed pods. Across the entire cohort, pooled S. aureus acquisition was significantly lower in infants housed in single-bed units (hazard ratio, =0.46; confidence interval, 0.34–0.62). CONCLUSIONS: NICU bed design is significantly associated with S. aureus acquisition in hospitalized infants independent of LOS. Infect Control Hosp Epidemiol 2018;39:46–52