Abstract | OBJECTIVE: To study the impact of methicillin-resistant Staphylococcus aureus (MRSA) surveillance on the incidence of MRSA-related bloodstream infection (BSI) in neonatal intensive care unit (NICU) and to evaluate cost-effectiveness of MRSA surveillance. STUDY DESIGN: MRSA surveillance policy was introduced in our NICU in April 2008. Pre-MRSA surveillance period (P1, April 2006-March 2008) was compared with the surveillance period (P2, April 2008-April 2010) for MRSA-related BSI (MRSA BSI). RESULTS: During P1 and P2, 1,576 and 1,512 neonates were enrolled. Of these, 3.8/1,000 and 5.3/1,000 developed MRSA BSI, respectively. During P2, 100% MRSA-related BSI occurred in MRSA-colonized neonates, as compared with zero in noncolonized group (p < 0.0001). Overall, 7 (30%) of the 23 neonates colonized during hospitalization developed MRSA BSI as compared with 1 of the 31 (3%) neonates colonized at admission (p = 0.007). Direct screening cost was $208 per patient. Since 28 neonates had to be screened to detect one colonization, $5,824 estimated per detection, excluding indirect costs. CONCLUSIONS: MRSA surveillance may protect non-MRSA colonized neonates from becoming colonized. This is of considerable importance because the acquisition of colonization during hospitalization was associated with a 10-fold increase in risk of developing MRSA BSI. Cost-effectiveness of MRSA surveillance remains debatable and further studies are needed to delineate cost-benefit ratio.
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Authors | Ashlesha Kaushik, Helen Kest, Adel Zauk, Vincent A DeBari, Michael Lamacchia |
Journal | American journal of perinatology
(Am J Perinatol)
Vol. 32
Issue 6
Pg. 531-6
(May 2015)
ISSN: 1098-8785 [Electronic] United States |
PMID | 25545444
(Publication Type: Journal Article)
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Copyright | Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA. |
Topics |
- Bacteremia
(epidemiology)
- Cross Infection
(epidemiology)
- Female
- Humans
- Infant, Newborn
- Intensive Care Units, Neonatal
- Male
- Methicillin-Resistant Staphylococcus aureus
(isolation & purification)
- Neonatal Screening
(economics)
- Staphylococcal Infections
(epidemiology)
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