耐甲氧西林金黄色葡萄球菌（MRSA）在纽约州（NYS）的新生儿重症监护病房（NICU）和其他新生儿病房中形成了聚集，时间范围为 2001 年至 2017 年。
Methicillin-resistant Staphylococcus aureus (MRSA) clusters in neonatal intensive care units (NICUs) and other neonatal units in New York State (NYS), 2001 to 2017.
机构信息
Healthcare Epidemiology and Infection Control Program, New York State Department of Health, New Rochelle, NY.
Healthcare Epidemiology and Infection Control Program, New York State Department of Health, Central Islip, NY.
出版信息
Am J Infect Control. 2024 Apr;52(4):424-435. doi: 10.1016/j.ajic.2023.09.015. Epub 2023 Sep 29.
BACKGROUND
New York State (NYS) mandates reporting of all hospital-associated communicable disease outbreaks. We describe trends in NYS surveillance for neonatal unit methicillin-resistant Staphylococcus aureus (MRSA) outbreaks, the evolution of national MRSA infection prevention and control (IPC) recommendations, and IPC measures taken by NYS neonatal units.
METHODS
We evaluated trends of reported neonatal unit MRSA outbreaks by etiology from 2001 to 2017. We reviewed all reports and the use of IPC recommendations over time.
RESULTS
From 2001 to 2017, 124 MRSA outbreaks were reported in 47 hospital neonatal units, with a total of 1,055 laboratory-confirmed infant cases, 18 infant deaths, and 52 laboratory-confirmed staff cases. The number of outbreaks increased with the level of care. During the study period, a higher proportion of hospitals reported implementing IPC measures, including reinforcing hand hygiene compliance (increased from 79.2% to 95.1%) and enhancing environmental cleaning and disinfection (increased from 4.2% to 78.0%) as well as performing active surveillance testing (AST) on exposed neonates (increased from 4.2% to 51.2%) and molecular testing on MRSA-positive isolates (increased from 5.3% to 18.9%).
CONCLUSIONS
From 2001 to 2017, IPC measures in neonatal units increased in parallel with expanded national IPC recommendations. However, MRSA outbreaks in neonatal units continued to be frequent occurrences in NYS.
背景
纽约州（NYS）要求报告所有与医院相关的传染病暴发。我们描述了 NYS 对新生儿病房耐甲氧西林金黄色葡萄球菌（MRSA）暴发的监测趋势、国家 MRSA 感染预防和控制（IPC）建议的演变以及 NYS 新生儿病房采取的 IPC 措施。
方法
我们评估了 2001 年至 2017 年报告的新生儿病房 MRSA 暴发的病因趋势。我们回顾了所有报告和随时间推移使用 IPC 建议的情况。
结果
从 2001 年至 2017 年，47 家医院新生儿病房共报告了 124 起 MRSA 暴发，共有 1055 例实验室确诊婴儿病例、18 例婴儿死亡和 52 例实验室确诊工作人员病例。暴发数量随护理水平的提高而增加。在研究期间，越来越多的医院报告实施了 IPC 措施，包括加强手卫生依从性（从 79.2%增加到 95.1%）和增强环境清洁和消毒（从 4.2%增加到 78.0%）以及对暴露的新生儿进行主动监测检测（AST）（从 4.2%增加到 51.2%）和对 MRSA 阳性分离物进行分子检测（从 5.3%增加到 18.9%）。
结论
从 2001 年至 2017 年，新生儿病房的 IPC 措施随着国家 IPC 建议的扩大而增加。然而，MRSA 暴发在 NYS 的新生儿病房仍频繁发生。
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