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Nasal Screening for MRSA in NICU Significantly Cuts Infection Rate


 

Major Finding: A total of 5 infants (0.15%) became infected in the NICU during the screening period, versus 29 (1.11%) during the period when screening was not performed.

Data Source: A retrospective study of 5,893 infants seen over two 42-month periods.

Disclosures: None was reported.

BETHESDA, MD. — Nasal screening for methicillin-resistant Staphylococcus aureus significantly reduced the infection rate in a neonatal intensive care unit, in a retrospective study of 5,893 infants seen over two 42-month periods.

Some U.S. states have enacted legislation for mandatory screening for nasal colonization with methicillin-resistant Staphylococcus aureus (MRSA) among inpatients in high-risk inpatient units, but there is still ongoing debate about the value of such screening, Dr. Jeremias L. Murillo said in a poster presented at the annual conference on antimicrobial resistance sponsored by the National Foundation for Infectious Diseases.

Records from January 2006 to June 2009, when all patients admitted to the NICU were screened for nasal carriage of MRSA, were compared with those from an equivalent 42-month period from July 2002 to December 2005, when no nasal screenings were performed. All MRSA infections were identified from a microbiology database and confirmed by chart review.

Nasal screenings were performed via rapid polymerase chain reaction testing, and infants found positive were decolonized with topical mupirocin, with contact isolation maintained until decolonization was completed.

There were no significant differences in birth weight or gestational age between the 3,269 infants who were screened and the 2,624 who were not.

A total of 5 infants (0.15%) became infected in the NICU during the screening period, compared with 29 (1.11%) during the period when screening was not performed, Dr. Murillo of Children's Hospital of New Jersey and Beth Israel Medical Center, Newark, reported.

In an interview, Dr. Murillo noted that in 2002 it took an average of 72 days from the time of admission before the infants became infected, compared with only 14 days in 2005, just before his hospital began screening.

“We felt that the shortened time frame was because the babies were coming into the NICU already colonized with MRSA and were therefore getting infected earlier,” he commented.

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