Effect of Contact Precautions on Staphylococcus aureus and Clinical Outcomes of Colonized Patients in the Neonatal Intensive Care Unit. Issue 11 (November 2020)

• Record Type: Journal Article
• Authors: Shahbaz, Sevini; de St. Maurice, Annabelle; Sim, Myung-Shin; Rubin, Zachary; Garg, Meena
• Is Part Of: Pediatric infectious disease journal. Volume 39:Issue 11(2020)
• Publication Date: 2020-11
• Subjects: Staphylococcus aureus -- neonate -- contact precautions; Communicable diseases in children -- Periodicals; Infection in children -- Periodicals; 618.929
• DOI: 10.1097/INF.0000000000002795
• Languages: English
• ISSNs: 0891-3668

Abstract

Abstract : Background: Staphylococcus aureus is a common pathogen in neonatal intensive care units (NICUs), yet little is known about the effect of contact precautions and clinical outcomes of colonized patients. Methods: Retrospective cohort study of all neonates from August 2014 to November 2018 colonized with either methicillin-resistant S. aureus (MRSA) or methicillin-susceptible S. aureus (MSSA) and select noncolonized patients at two neonatal intensive care units at the University of California, Los Angeles. Outcomes during two time periods (during and after the use of contact precautions) were assessed. Results: A total of 234 patients were included in the study: 83 colonized and 151 noncolonized patients. There was a fourfold higher incidence of MSSA colonization versus MRSA ( P < 0.001). There was a higher incidence of positive surveillance cultures after contact precautions were discontinued ( P = 0.01), but this did not correlate with a higher incidence of invasive cultures ( P = 0.475). There were twice as many MSSA invasive cultures than MRSA, but a higher rate of invasion with MRSA ( P < 0.05). Colonized patients were more likely to develop an invasive infection than noncolonized ( P = 0.003 MRSA; P = 0.004 MSSA). When controlling for gestational age and surgical interventions, colonization was more likely to be associated with skin and soft tissue infections ( P < 0.001) and a longer length of stay by a mean of 27.8 days ( P < 0.0001). Conclusions: Contact precautions resulted in a lower incidence of colonization without a difference in invasive cultures in our NICUs. Those colonized with S. aureus had a higher incidence of skin and soft tissue infections and a longer NICU length of stay. Abstract : Supplemental Digital Content is available in the text.