Methicillin-resistant Staphylococcus aureus bacteraemia in neonatal intensive care units

An analysis of 90 episodes

Y. Y. Chuang, Y. C. Huang, C. Y. Lee, T. Y. Lin, R. Lien, Y. H. Chou

Research output: Contribution to journalReview article

38 Citations (Scopus)

Abstract

Aim: To delineate the clinical features of methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia in infants hospitalized at the neonatal intensive care unit. Methods: Episodes of MRSA bacteraemia in Chang Gung Children's Hospital neonatal intensive care unit from 1997 to 1999 were reviewed for incidence, predisposing factors, clinical presentations, treatment and outcome. Results: Ninety episodes of MRSA bacteraemia were identified. The overall rate of MRSA bacteraemia was 1.05 per 1000 patient days during the 3-y period. Most of the patients were premature infants (76%), with prior operation or invasive procedures (39%), had an indwelling intravascular catheter (79%) and exposure to antibiotic therapy (96%). A localized cutaneous infection was found in 53.3% of the episodes. The most common clinical diagnoses were catheter-related infections (54.4%), skin and soft tissue infections (21.1%), bacteraemia without a focus (20%) and pneumonia (16.7%). Metastatic infection occurred in 18% of these infants. Among the patients treated with vancomycin for ≤14 d, 88.7% did not develop any complications, and 11.3% developed a recurrence. Conclusions: MRSA is an established pathogen in our NICU. MRSA bacteraemia in the neonates predominantly presented as catheter-related infections, and metastatic infections were not infrequently seen. In uncomplicated MRSA bacteraemia, treatment with vancomycin for ≤14 d seems to be adequate.

Original languageEnglish
Pages (from-to)786-790
Number of pages5
JournalActa Paediatrica, International Journal of Paediatrics
Volume93
Issue number6
DOIs
Publication statusPublished - Jun 2004
Externally publishedYes

Fingerprint

Neonatal Intensive Care Units
Methicillin-Resistant Staphylococcus aureus
Bacteremia
Catheter-Related Infections
Vancomycin
Infection
Skin
Soft Tissue Infections
Indwelling Catheters
Premature Infants
Causality
Pneumonia
Newborn Infant
Anti-Bacterial Agents
Recurrence
Incidence
Therapeutics

Keywords

  • Bacteraemia
  • Methicillin-resistant Staphylococcus aureus
  • Neonatal intensive care units
  • Nosocomial infection

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Methicillin-resistant Staphylococcus aureus bacteraemia in neonatal intensive care units : An analysis of 90 episodes. / Chuang, Y. Y.; Huang, Y. C.; Lee, C. Y.; Lin, T. Y.; Lien, R.; Chou, Y. H.

In: Acta Paediatrica, International Journal of Paediatrics, Vol. 93, No. 6, 06.2004, p. 786-790.

Research output: Contribution to journalReview article

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abstract = "Aim: To delineate the clinical features of methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia in infants hospitalized at the neonatal intensive care unit. Methods: Episodes of MRSA bacteraemia in Chang Gung Children's Hospital neonatal intensive care unit from 1997 to 1999 were reviewed for incidence, predisposing factors, clinical presentations, treatment and outcome. Results: Ninety episodes of MRSA bacteraemia were identified. The overall rate of MRSA bacteraemia was 1.05 per 1000 patient days during the 3-y period. Most of the patients were premature infants (76{\%}), with prior operation or invasive procedures (39{\%}), had an indwelling intravascular catheter (79{\%}) and exposure to antibiotic therapy (96{\%}). A localized cutaneous infection was found in 53.3{\%} of the episodes. The most common clinical diagnoses were catheter-related infections (54.4{\%}), skin and soft tissue infections (21.1{\%}), bacteraemia without a focus (20{\%}) and pneumonia (16.7{\%}). Metastatic infection occurred in 18{\%} of these infants. Among the patients treated with vancomycin for ≤14 d, 88.7{\%} did not develop any complications, and 11.3{\%} developed a recurrence. Conclusions: MRSA is an established pathogen in our NICU. MRSA bacteraemia in the neonates predominantly presented as catheter-related infections, and metastatic infections were not infrequently seen. In uncomplicated MRSA bacteraemia, treatment with vancomycin for ≤14 d seems to be adequate.",
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AU - Lien, R.

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N2 - Aim: To delineate the clinical features of methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia in infants hospitalized at the neonatal intensive care unit. Methods: Episodes of MRSA bacteraemia in Chang Gung Children's Hospital neonatal intensive care unit from 1997 to 1999 were reviewed for incidence, predisposing factors, clinical presentations, treatment and outcome. Results: Ninety episodes of MRSA bacteraemia were identified. The overall rate of MRSA bacteraemia was 1.05 per 1000 patient days during the 3-y period. Most of the patients were premature infants (76%), with prior operation or invasive procedures (39%), had an indwelling intravascular catheter (79%) and exposure to antibiotic therapy (96%). A localized cutaneous infection was found in 53.3% of the episodes. The most common clinical diagnoses were catheter-related infections (54.4%), skin and soft tissue infections (21.1%), bacteraemia without a focus (20%) and pneumonia (16.7%). Metastatic infection occurred in 18% of these infants. Among the patients treated with vancomycin for ≤14 d, 88.7% did not develop any complications, and 11.3% developed a recurrence. Conclusions: MRSA is an established pathogen in our NICU. MRSA bacteraemia in the neonates predominantly presented as catheter-related infections, and metastatic infections were not infrequently seen. In uncomplicated MRSA bacteraemia, treatment with vancomycin for ≤14 d seems to be adequate.

AB - Aim: To delineate the clinical features of methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia in infants hospitalized at the neonatal intensive care unit. Methods: Episodes of MRSA bacteraemia in Chang Gung Children's Hospital neonatal intensive care unit from 1997 to 1999 were reviewed for incidence, predisposing factors, clinical presentations, treatment and outcome. Results: Ninety episodes of MRSA bacteraemia were identified. The overall rate of MRSA bacteraemia was 1.05 per 1000 patient days during the 3-y period. Most of the patients were premature infants (76%), with prior operation or invasive procedures (39%), had an indwelling intravascular catheter (79%) and exposure to antibiotic therapy (96%). A localized cutaneous infection was found in 53.3% of the episodes. The most common clinical diagnoses were catheter-related infections (54.4%), skin and soft tissue infections (21.1%), bacteraemia without a focus (20%) and pneumonia (16.7%). Metastatic infection occurred in 18% of these infants. Among the patients treated with vancomycin for ≤14 d, 88.7% did not develop any complications, and 11.3% developed a recurrence. Conclusions: MRSA is an established pathogen in our NICU. MRSA bacteraemia in the neonates predominantly presented as catheter-related infections, and metastatic infections were not infrequently seen. In uncomplicated MRSA bacteraemia, treatment with vancomycin for ≤14 d seems to be adequate.

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