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dc.contributor.authorBrown, NMen
dc.contributor.authorReacher, Men
dc.contributor.authorRice, Wen
dc.contributor.authorRoddick, Ien
dc.contributor.authorReeve, Len
dc.contributor.authorVerlander, NQen
dc.contributor.authorBroster, Sen
dc.contributor.authorOgilvy-Stuart, ALen
dc.contributor.authorD'Amore, Aen
dc.contributor.authorAhluwalia, Jen
dc.contributor.authorRobinson, Sen
dc.contributor.authorThaxter, Ren
dc.contributor.authorMoody, Cen
dc.contributor.authorKearns, Aen
dc.contributor.authorGreatorex, Jen
dc.contributor.authorMartin, Howarden
dc.contributor.authorTörök, MEen
dc.contributor.authorEnoch, DAen
dc.date.accessioned2019-08-12T23:30:19Z
dc.date.available2019-08-12T23:30:19Z
dc.date.issued2019-05-24en
dc.identifier.issn0195-6701
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/295682
dc.description.abstractAIM: To describe the investigation and management of a meticillin-resistant Staphylococcus aureus (MRSA) outbreak on a neonatal intensive care unit (NICU) and the lessons learnt. METHODS: This was an outbreak report and case-control study conducted in a 40-cot NICU in a tertiary referral hospital and included all infants colonized/infected with gentamicin-resistant MRSA. INTERVENTION: Standard infection-control measures including segregation of infants, barrier precautions, enhanced cleaning, assessment of staff practice including hand hygiene, and increased MRSA screening of infants were implemented. Continued MRSA acquisitions led to screening of all NICU staff. A case-control study was performed to assess staff contact with colonized babies and inform the management of the outbreak. FINDINGS: Eight infants were colonized with MRSA (spa type t2068), one of whom subsequently developed an MRSA bacteraemia. MRSA colonization was significantly associated with lower gestational age; lower birthweight and with being a twin. Three nurses were MRSA colonized but only one nurse (45) was colonized with MRSA spa type t2068. Multivariable logistic regression analysis identified being cared for by nurse 45 as an independent risk factor for MRSA colonization. CONCLUSIONS: Lack of accurate recording of which nurses looked after which infants (and when) made identification of the risk posed by being cared for by particular nurses difficult. If this had been clearer, it may have enabled earlier identification of the colonized nurse, avoiding subsequent cases. This study highlights the benefit of using a case-control study, which showed that most nurses had no association with colonized infants.
dc.description.sponsorshipThis study was not funded. MET is a Clinician Scientist Fellow supported by the Academy of Medical Sciences, the Health Foundation and the NIHR Cambridge Biomedical Research Centre.
dc.languageengen
dc.publisherW. B. Saunders Co., Ltd.
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectMRSAen
dc.subjectNeonatal intensive careen
dc.subjectNeonatesen
dc.subjectOutbreaken
dc.titleAn outbreak of meticillin-resistant Staphylococcus aureus colonization in a neonatal intensive care unit: use of a case-control study to investigate and control it and lessons learnt.en
dc.typeArticle
prism.publicationDate2019en
prism.publicationNameJournal of Hospital Infectionen
dc.identifier.doi10.17863/CAM.42731
dcterms.dateAccepted2019-05-20en
rioxxterms.versionofrecord10.1016/j.jhin.2019.05.009en
rioxxterms.versionAM
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden
rioxxterms.licenseref.startdate2019-05-24en
dc.identifier.eissn1532-2939
rioxxterms.typeJournal Article/Reviewen
pubs.funder-project-idAcademy of Medical Sciences (unknown)
pubs.funder-project-idMRC (MR/N029399/1)
dc.identifier.urlhttps://www.sciencedirect.com/science/article/pii/S0195670119302221?via%3Dihub#!en
cam.orpheus.successThu Jan 30 10:41:03 GMT 2020 - Embargo updated*
rioxxterms.freetoread.startdate2020-05-24


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Attribution-NonCommercial-NoDerivatives 4.0 International
Except where otherwise noted, this item's licence is described as Attribution-NonCommercial-NoDerivatives 4.0 International