Staphylococcus aureus infections in Australasian neonatal nurseries

被引:38
作者
Isaacs, D
Fraser, S
Hogg, G
Li, HY
机构
[1] Childrens Hosp Westmead, Dept Immunol & Infect Dis, Westmead, NSW 2145, Australia
[2] Mercy Hosp Women, Melbourne, Vic 3002, Australia
[3] Univ Melbourne, Microbiol Diagnost Unit, Parkville, Vic 3052, Australia
来源
ARCHIVES OF DISEASE IN CHILDHOOD-FETAL AND NEONATAL EDITION | 2004年 / 89卷 / 04期
关键词
D O I
10.1136/adc.2002.009480
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Objective: To study the incidence and outcome of systemic infections with methicillin sensitive (MSSA) and methicillin resistant Staphylococcus aureus (MRSA) infections in Australasian neonatal nurseries. Methods: Prospective longitudinal study of systemic infections ( clinical sepsis plus positive cultures of blood and/or cerebrospinal fluid) in 17 Australasian neonatal nurseries. Results: The incidence of early onset sepsis with S aureus, mainly MSSA, was 19 cases per 244 718 live births or 0.08 per 1000. From 1992 to 1994, MRSA infections caused only 8% of staphylococcal infections. From 1995 to 1998, there was an outbreak of MRSA infection, in two Melbourne hospitals. The outbreak resolved, after the use of topical mupirocin and improved handwashing. Babies with MRSA sepsis were significantly smaller than babies with MSSA sepsis ( mean birth weight 1093 v 1617 g) and more preterm ( mean gestation 27.5 v 30.3 weeks). The mortality of MRSA sepsis was 24.6% compared with 9.9% for MSSA infections. The mortality of early onset MSSA sepsis, however, was 39% ( seven of 18) compared with 7.3% of late onset MSSA infection presenting more than two days after birth. Conclusions: S aureus is a rare but important cause of early onset sepsis. Late onset MRSA infections carried a higher mortality than late onset MSSA infections, but babies with early onset MSSA sepsis had a particularly high mortality.
引用
收藏
页码:F331 / F335
页数:5
相关论文
共 29 条
[1]  
Back NA, 1996, INFECT CONT HOSP EP, V17, P227
[2]   An epidemiological survey of methicillin-resistant Staphylococcus aureus in a tertiary referral hospital [J].
Barakate, MS ;
Yang, YX ;
Foo, SH ;
Vickery, AM ;
Sharp, CA ;
Fowler, LD ;
Harris, JP ;
West, RH ;
Macleod, C ;
Benn, RA .
JOURNAL OF HOSPITAL INFECTION, 2000, 44 (01) :19-26
[3]  
Cheong I, 1994, Med J Malaysia, V49, P24
[4]   AN OUTBREAK OF INFECTION WITH A METHICILLIN-RESISTANT STAPHYLOCOCCUS-AUREUS IN A SPECIAL CARE BABY UNIT - VALUE OF TOPICAL MUPIROCIN AND OF TRADITIONAL METHODS OF INFECTION CONTROL [J].
DAVIES, EA ;
EMMERSON, AM ;
HOGG, GM ;
PATTERSON, MF ;
SHIELDS, MD .
JOURNAL OF HOSPITAL INFECTION, 1987, 10 (02) :120-128
[5]   Evolution of an endemic methicillin-resistant Staphylococcus aureus population in an Australian hospital from 1967 to 1996 [J].
Givney, R ;
Vickery, A ;
Holliday, A ;
Pegler, M ;
Benn, R .
JOURNAL OF CLINICAL MICROBIOLOGY, 1998, 36 (02) :552-556
[6]   The independent evolution of resistance to ciprofloxacin, rifampicin, and fusidic acid in methicillin-resistant Staphylococcus aureus in Australian teaching hospitals (1990-1995) [J].
Gottlieb, T ;
Mitchell, D .
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, 1998, 42 (01) :67-73
[7]   OUTBREAK OF METHICILLIN-RESISTANT STAPHYLOCOCCUS-AUREUS IN A NEONATAL INTENSIVE-CARE UNIT [J].
HADDAD, Q ;
SOBAYO, EI ;
BASIT, OBA ;
ROTIMI, VO .
JOURNAL OF HOSPITAL INFECTION, 1993, 23 (03) :211-221
[8]   THE ROLE OF UNDERSTAFFING AND OVERCROWDING IN RECURRENT OUTBREAKS OF STAPHYLOCOCCAL INFECTION IN A NEONATAL SPECIAL-CARE UNIT [J].
HALEY, RW ;
BREGMAN, DA .
JOURNAL OF INFECTIOUS DISEASES, 1982, 145 (06) :875-885
[9]   ERADICATION OF ENDEMIC METHICILLIN-RESISTANT STAPHYLOCOCCUS-AUREUS INFECTIONS FROM A NEONATAL INTENSIVE-CARE UNIT [J].
HALEY, RW ;
CUSHION, NB ;
TENOVER, FC ;
BANNERMAN, TL ;
DRYER, D ;
ROSS, J ;
SANCHEZ, PJ ;
SIEGEL, JD .
JOURNAL OF INFECTIOUS DISEASES, 1995, 171 (03) :614-624
[10]  
HEFFERNAN H, 1993, NEW ZEAL MED J, V106, P72