Effect of mupirocin decolonization on subsequent methicillin-resistant Staphylococcus aureus infection in infants in neonatal intensive care units

Yhu Chering Huang, Rey In Lien, Tzou Yien Lin

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Objective: To evaluate whether topical mupirocin treatment can effectively decolonize methicillin-resistant Staphylococcus aureus (MRSA) carriage and reduce subsequent MRSA infection in neonates. Methods: During a 1-year period, the infants admitted to our neonatal intensive care units (NICUs)-1 and NICU-2 were included, and specimens from the nares and umbilicus were obtained within 24 hours, and specimen collection was repeated weekly for 2 weeks. Mupirocin was administered for 5 days to the infants with MRSA colonization in NICU-1 during the first half of the year and then switched to those in NICU-2 during the second half of the year. Results: A total of 525 infants were recruited: 257 infants in the treatment group and 268 in the control group. MRSA colonization was detected in 130 infants (25%) during NICU stay, which is a similar rate in both groups. Twenty-two (4.2%) episodes of MRSA infection were identified. The rate of MRSA infection was significantly higher in infants with prior colonization than in those without (10.2% vs. 2.3%, P < 0.001). Among the infants with prior colonization, the rate of MRSA infection in the treatment group was significantly lower than that in the control group (3.2% vs. 16%, P = 0.014), and the rate in the treatment group was comparable to that in those without colonization (P = 0.7804). Of the 15 infants with both clinical and colonizing isolates, indistinguishable strains between the paired isolates from the same infant by molecular methods were identified in 14 infants (93%). Conclusion: Administering mupirocin topical therapy to MRSA-colonized infants in NICUs might reduce subsequent MRSA infections during hospitalization in these infants. A large-scale study should be conducted.

Original languageEnglish
Pages (from-to)241-245
Number of pages5
JournalPediatric Infectious Disease Journal
Volume34
Issue number3
DOIs
Publication statusPublished - Mar 4 2015
Externally publishedYes

Fingerprint

Mupirocin
Neonatal Intensive Care Units
Methicillin-Resistant Staphylococcus aureus
Infection
Specimen Handling
Therapeutics
Umbilicus
Control Groups

Keywords

  • Colonization
  • Infection
  • Methicillin-resistant Staphylococcus aureus
  • Mupirocin
  • Neonatal intensive care unit

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Medicine(all)
  • Microbiology (medical)
  • Infectious Diseases

Cite this

Effect of mupirocin decolonization on subsequent methicillin-resistant Staphylococcus aureus infection in infants in neonatal intensive care units. / Huang, Yhu Chering; Lien, Rey In; Lin, Tzou Yien.

In: Pediatric Infectious Disease Journal, Vol. 34, No. 3, 04.03.2015, p. 241-245.

Research output: Contribution to journalArticle

@article{548d2f4feedd4ff4b1fa3afcd8147270,
title = "Effect of mupirocin decolonization on subsequent methicillin-resistant Staphylococcus aureus infection in infants in neonatal intensive care units",
abstract = "Objective: To evaluate whether topical mupirocin treatment can effectively decolonize methicillin-resistant Staphylococcus aureus (MRSA) carriage and reduce subsequent MRSA infection in neonates. Methods: During a 1-year period, the infants admitted to our neonatal intensive care units (NICUs)-1 and NICU-2 were included, and specimens from the nares and umbilicus were obtained within 24 hours, and specimen collection was repeated weekly for 2 weeks. Mupirocin was administered for 5 days to the infants with MRSA colonization in NICU-1 during the first half of the year and then switched to those in NICU-2 during the second half of the year. Results: A total of 525 infants were recruited: 257 infants in the treatment group and 268 in the control group. MRSA colonization was detected in 130 infants (25{\%}) during NICU stay, which is a similar rate in both groups. Twenty-two (4.2{\%}) episodes of MRSA infection were identified. The rate of MRSA infection was significantly higher in infants with prior colonization than in those without (10.2{\%} vs. 2.3{\%}, P < 0.001). Among the infants with prior colonization, the rate of MRSA infection in the treatment group was significantly lower than that in the control group (3.2{\%} vs. 16{\%}, P = 0.014), and the rate in the treatment group was comparable to that in those without colonization (P = 0.7804). Of the 15 infants with both clinical and colonizing isolates, indistinguishable strains between the paired isolates from the same infant by molecular methods were identified in 14 infants (93{\%}). Conclusion: Administering mupirocin topical therapy to MRSA-colonized infants in NICUs might reduce subsequent MRSA infections during hospitalization in these infants. A large-scale study should be conducted.",
keywords = "Colonization, Infection, Methicillin-resistant Staphylococcus aureus, Mupirocin, Neonatal intensive care unit",
author = "Huang, {Yhu Chering} and Lien, {Rey In} and Lin, {Tzou Yien}",
year = "2015",
month = "3",
day = "4",
doi = "10.1097/INF.0000000000000540",
language = "English",
volume = "34",
pages = "241--245",
journal = "Pediatric Infectious Disease Journal",
issn = "0891-3668",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Effect of mupirocin decolonization on subsequent methicillin-resistant Staphylococcus aureus infection in infants in neonatal intensive care units

AU - Huang, Yhu Chering

AU - Lien, Rey In

AU - Lin, Tzou Yien

PY - 2015/3/4

Y1 - 2015/3/4

N2 - Objective: To evaluate whether topical mupirocin treatment can effectively decolonize methicillin-resistant Staphylococcus aureus (MRSA) carriage and reduce subsequent MRSA infection in neonates. Methods: During a 1-year period, the infants admitted to our neonatal intensive care units (NICUs)-1 and NICU-2 were included, and specimens from the nares and umbilicus were obtained within 24 hours, and specimen collection was repeated weekly for 2 weeks. Mupirocin was administered for 5 days to the infants with MRSA colonization in NICU-1 during the first half of the year and then switched to those in NICU-2 during the second half of the year. Results: A total of 525 infants were recruited: 257 infants in the treatment group and 268 in the control group. MRSA colonization was detected in 130 infants (25%) during NICU stay, which is a similar rate in both groups. Twenty-two (4.2%) episodes of MRSA infection were identified. The rate of MRSA infection was significantly higher in infants with prior colonization than in those without (10.2% vs. 2.3%, P < 0.001). Among the infants with prior colonization, the rate of MRSA infection in the treatment group was significantly lower than that in the control group (3.2% vs. 16%, P = 0.014), and the rate in the treatment group was comparable to that in those without colonization (P = 0.7804). Of the 15 infants with both clinical and colonizing isolates, indistinguishable strains between the paired isolates from the same infant by molecular methods were identified in 14 infants (93%). Conclusion: Administering mupirocin topical therapy to MRSA-colonized infants in NICUs might reduce subsequent MRSA infections during hospitalization in these infants. A large-scale study should be conducted.

AB - Objective: To evaluate whether topical mupirocin treatment can effectively decolonize methicillin-resistant Staphylococcus aureus (MRSA) carriage and reduce subsequent MRSA infection in neonates. Methods: During a 1-year period, the infants admitted to our neonatal intensive care units (NICUs)-1 and NICU-2 were included, and specimens from the nares and umbilicus were obtained within 24 hours, and specimen collection was repeated weekly for 2 weeks. Mupirocin was administered for 5 days to the infants with MRSA colonization in NICU-1 during the first half of the year and then switched to those in NICU-2 during the second half of the year. Results: A total of 525 infants were recruited: 257 infants in the treatment group and 268 in the control group. MRSA colonization was detected in 130 infants (25%) during NICU stay, which is a similar rate in both groups. Twenty-two (4.2%) episodes of MRSA infection were identified. The rate of MRSA infection was significantly higher in infants with prior colonization than in those without (10.2% vs. 2.3%, P < 0.001). Among the infants with prior colonization, the rate of MRSA infection in the treatment group was significantly lower than that in the control group (3.2% vs. 16%, P = 0.014), and the rate in the treatment group was comparable to that in those without colonization (P = 0.7804). Of the 15 infants with both clinical and colonizing isolates, indistinguishable strains between the paired isolates from the same infant by molecular methods were identified in 14 infants (93%). Conclusion: Administering mupirocin topical therapy to MRSA-colonized infants in NICUs might reduce subsequent MRSA infections during hospitalization in these infants. A large-scale study should be conducted.

KW - Colonization

KW - Infection

KW - Methicillin-resistant Staphylococcus aureus

KW - Mupirocin

KW - Neonatal intensive care unit

UR - http://www.scopus.com/inward/record.url?scp=84924202198&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84924202198&partnerID=8YFLogxK

U2 - 10.1097/INF.0000000000000540

DO - 10.1097/INF.0000000000000540

M3 - Article

C2 - 25742074

AN - SCOPUS:84924202198

VL - 34

SP - 241

EP - 245

JO - Pediatric Infectious Disease Journal

JF - Pediatric Infectious Disease Journal

SN - 0891-3668

IS - 3

ER -