Academic Department of Paediatrics, National University of Ireland, Galway, Ireland.
Academic Department of Paediatrics, National University of Ireland, Galway, Ireland.
J Hosp Infect. 2018 Nov;100(3):329-336. doi: 10.1016/j.jhin.2018.07.006. Epub 2018 Sep 13.
Neonatal sepsis is a leading cause of morbidity and mortality in neonatal units worldwide. Meticillin-resistant Staphylococcus aureus (MRSA) has become a leading causative pathogen. Many neonatal units experience endemic colonization and infection of their infants, which is often very challenging to successfully eradicate.
To assess the impact of neonatal unit refurbishment and redesign on endemic MRSA colonization and infection.
A retrospective review was carried out over an eight-year period in a 14-cot, level 2-3 neonatal unit in University Hospital Galway, a large university teaching hospital in the West of Ireland. Surveillance, colonization, and infection data for a four-year period pre and four-year period post neonatal unit refurbishment are described. Clinical and microbiological data were collected on all MRSA-colonized and -infected infants between 2008 and 2015. Molecular typing data are available for MRSA isolates. An interrupted time-series design was used, with unit refurbishment as the intervention.
Our neonatal unit had a pattern of sustained transmission of endemic resident MRSA strains which we could not eradicate despite repeated standard infection control interventions. Complete unit refurbishment led to successful termination of sustained transmission of these strains. Colonization decreased and no infants were actively infected post refurbishment of the unit.
We report successful termination of sustained transmission of endemic strains of MRSA from our neonatal unit following complete unit redesign and refurbishment.
新生儿败血症是全球新生儿病房发病率和死亡率的主要原因。耐甲氧西林金黄色葡萄球菌（MRSA）已成为主要的致病病原体。许多新生儿病房都经历过婴儿的地方性定植和感染，这通常很难成功根除。
评估新生儿病房翻新和重新设计对地方性 MRSA 定植和感染的影响。
对爱尔兰西部一家大型大学教学医院戈尔韦大学医院的一个 14 张床、2-3 级新生儿病房进行了为期八年的回顾性研究。描述了翻新前四年和翻新后四年的监测、定植和感染数据。收集了 2008 年至 2015 年间所有 MRSA 定植和感染婴儿的临床和微生物学数据。MRSA 分离株可提供分子分型数据。采用中断时间序列设计，以病房翻新作为干预措施。
我们的新生儿病房存在地方性常驻 MRSA 菌株的持续传播模式，尽管反复进行了标准感染控制干预，我们仍无法根除这些菌株。彻底的病房翻新导致这些菌株的持续传播成功终止。定植减少，单位翻新后没有婴儿被主动感染。
我们报告了通过彻底的病房重新设计和翻新成功终止了我们新生儿病房地方性 MRSA 菌株的持续传播。
