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Logo of bmcpediBioMed Centralsearchsubmit a manuscriptregisterthis articleBMC Pediatrics
 
BMC Pediatr. 2012; 12: 64.
Published online Jun 8, 2012. doi:  10.1186/1471-2431-12-64
PMCID: PMC3407518
Epidemic spread of ST1-MRSA-IVa in a neonatal intensive care unit, Italy
Mario Giuffrè,1 Domenico Cipolla,1 Celestino Bonura,2 Daniela Maria Geraci,2,3 Aurora Aleo,2 Stefania Di Noto,1 Federica Nociforo,1 Giovanni Corsello,1 and Caterina Mamminacorresponding author2
1Department of Mother and Child, University of Palermo, I-90127, Palermo, Italy
2Department of Sciences for Health Promotion “G. D’ Alessandro”, University of Palermo, Via del Vespro 133, I-90127, Palermo, Italy
3PhD School in Food and Human Nutrition, University of Palermo, I-90127, Palermo, Italy
corresponding authorCorresponding author.
Mario Giuffrè: mariogiuffre/at/unipa.it; Domenico Cipolla: cipolladomenico/at/libero.it; Celestino Bonura: celestino.bonura/at/unipa.it; Daniela Maria Geraci: geracidaniela/at/yahoo.it; Aurora Aleo: auroraaleo/at/libero.it; Stefania Di Noto: stefydinoto/at/tiscali.it; Federica Nociforo: anglesite/at/libero.it; Giovanni Corsello: giovanni.corsello/at/unipa.it; Caterina Mammina: caterina.mammina/at/unipa.it
Received January 11, 2012; Accepted June 8, 2012.
Abstract
Background
Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has recently emerged as an important pathogen in neonatal intensive care units (NICUs). The purposes of this study were to characterize methicillin-resistant isolates from an outbreak in a NICU, to examine the genetic traits and clonality of CA-MRSA, and to review the characteristics and outcomes of the neonatal cases and investigate the routes of entry and transmission of the MRSA outbreak strain in the NICU under study.
Methods
The study NICU practiced an active surveillance program for multidrug-resistant organisms, including weekly cultures for detection of MRSA from nasal swabs among all the admitted neonates. All first isolates from surveillance cultures and all clinical isolates were submitted for susceptibility testing and genotyping. Data from each infant’s medical records were prospectively included in a database, and the clinical features and outcomes of the colonized/infected infants were assessed.
Results
A total of 14 infants were colonized or infected by a strain of ST1-MRSA-IVa between April and August 2011. The CA-MRSA strain appeared to have been introduced to the NICU by an infected infant transferred from another hospital. The outbreak was successfully contained by multifaceted infection control interventions.
Conclusions
The results of this study confirm that NICU is a healthcare setting with a critical permeability to CA-MRSA. Active surveillance including molecular typing can help to detect and monitor the spread of antimicrobial drug-resistant organisms, and thus trigger timely control interventions.
Keywords: CA-MRSA, NICU, Epidemiology, Infection control
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