Staphylococcal aureus outbreaks in neonatal intensive care units: strategies, nuances, and lessons learned from the frontline.

Antimicrobial stewardship & healthcare epidemiology : ASHE Pub Date : 2024-05-02 eCollection Date: 2024-01-01 DOI:10.1017/ash.2024.59
Christopher M Rooney, Rebecca Lancaster, Liz McKechnie, Kavita Sethi
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Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) infections in neonates can result in significant morbidity and mortality. However, comparatively to adults, neonatal MRSA data remains relatively scarce. Additionally, while evidence-driven practices for adults have seen considerable progress, neonatal infection prevention strategies remain poorly described. The Leeds Newborn Service adopted a series of infection prevention and control (IPC) measures following a rise in MRSA cases in 2008-2009. This narrative review presents IPC measures for neonatal MRSA and methicillin-sensitive Staphylococcus aureus (MSSA) infections and reflects upon local challenges and successes of these interventions. Our experience underscores the importance of an adaptive, evidence-based strategy, tailored to the neonatal population. Effectively addressing MRSA/MSSA requires continuous monitoring with sustained targeted interventions. Our key learning points highlight the intertwined difficulties of specific neonatal requirements and lack of definitive IPC guidance, suggesting a holistic approach is key for successful IPC outcomes in the neonatal intensive care unit setting.

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新生儿重症监护室爆发金黄色葡萄球菌:前线的策略、细微差别和经验教训。
新生儿耐甲氧西林金黄色葡萄球菌(MRSA)感染可导致严重的发病率和死亡率。然而,与成人相比,新生儿 MRSA 数据仍然相对匮乏。此外,虽然针对成人的循证实践已经取得了长足的进步,但新生儿感染预防策略的描述仍然很少。2008-2009 年 MRSA 病例增加后,利兹新生儿服务机构采取了一系列感染预防和控制 (IPC) 措施。这篇叙述性综述介绍了针对新生儿 MRSA 和对甲氧西林敏感的金黄色葡萄球菌 (MSSA) 感染的 IPC 措施,并反思了这些干预措施在当地面临的挑战和取得的成功。我们的经验强调了针对新生儿群体制定适应性强、以证据为基础的策略的重要性。要有效解决 MRSA/MSSA 问题,就必须持续监测并采取有针对性的干预措施。我们的主要学习要点强调了新生儿的特殊要求与缺乏明确的 IPC 指导之间相互交织的困难,这表明综合方法是新生儿重症监护病房成功实现 IPC 的关键。
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