Journal Mobile Options
Table of Contents
Vol. 105, No. 2, 2014
Issue release date: February 2014
Neonatology 2014;105:142-148

Prevalence and Molecular Characterization of Staphylococcus aureus Colonization among Neonatal Intensive Care Units in Taiwan

Kuo C.-Y. · Huang Y.-C. · Huang D.T.-N. · Chi H. · Lu C.-Y. · Chang L.-Y. · Chi C.-Y. · Ho Y.-H. · Huang Y.-C. · Liu C.-C. · Huang L.-M.
aTaiwan Pediatric Infectious Diseases Alliance, bDepartment of Pediatrics, Chang Gung Memorial Hospital at Linkou, and cGraduate Institute of Clinical Medical Sciences, dCollege of Medicine, Chang Gung University, Taoyuan, eDivision of Infectious Diseases, Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, fDepartment of Pediatrics, Mackay Memorial Hospital, and gDepartment of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, hNational Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, iDepartment of Pediatrics, Buddhist Tzu Chi General Hospital, Hualien, and jDepartment of Pediatrics, National Cheng-Kung University Hospital, Tainan, Taiwan

Individual Users: Register with Karger Login Information

Please create your User ID & Password

Contact Information

I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in


Background:Staphylococcus aureus, particularly methicillin-resistant (MRSA), is an important pathogen in neonatal intensive care units (NICUs). Carriage of S. aureus is a significant risk factor for subsequent infection. Objectives: To determine the current status of MRSA prevalence among NICU-hospitalized infants in Taiwan, we conducted this pilot island-wide survey. Methods: On two designated dates in 2011, each patient who stayed in the NICUs of 7 participating hospitals was included. Nasal and umbilical swabs were obtained and sent for detection of S. aureus. The prevalence and risk factors for MRSA carriage were analyzed. MRSA strains were tested for antimicrobial susceptibility and underwent molecular characterization. Results: A total of 251 subjects were included. The overall prevalence of S. aureus and MRSA carriage was 13 and 4.4%, respectively. Previous skin and soft tissue infection was the only predictor in multivariate analysis (OR 40.36; 95% CI 2.32-702.64; p = 0.011). Among 11 MRSA isolates, 3 pulsotypes were identified, with one major type (73%). Nine isolates carried a type IV staphylococcal chromosomal cassette, and 2 carried the type VT. All but one MRSA isolate belonged to linage sequence type 59, the community clone in Taiwan. Conclusions: On a designated date, 4.4% of the infants staying in NICUs in Taiwan carried almost genetically identical community strains of MRSA. MRSA colonization in these infants was significantly associated with previous skin and soft tissue infection. © 2013 S. Karger AG, Basel

Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.


  1. Song X, Perencevich E, Campos J, Short BL, Singh N: Clinical and economic impact of methicillin-resistant Staphylococcus aureus colonization or infection on neonates in intensive care units. Infect Control Hosp Epidemiol 2010;31:177-182.
  2. Lessa FC, Edwards JR, Fridkin SK, Tenover FC, Horan TC, Gorwitz RJ: Trends in incidence of late-onset methicillin-resistant Staphylococcus aureus infection in neonatal intensive care units: data from the National Nosocomial Infections Surveillance System, 1995-2004. Pediatr Infect Dis J 2009;28:577-581.
  3. Chuang YY, Huang YC, Lee CY, Lin TY, Lien R, Chou YM: Methicillin-resistant Staphylococcus aureus bacteraemia in neonatal intensive care units: an analysis of 90 episodes. Acta Paediatr 2004;93:786-790.
  4. Huang YC, Chou YH, Su LH, Lien RI, Lin TY: Methicillin-resistant Staphylococcus aureus colonization and its association with infection among infants hospitalized in neonatal intensive care units. Pediatrics 2006;118:469-474.
  5. Wertheim HF, Vos MC, Ott A, van Belkum A, Kluytmans JA, van Keulen PH, Vandenbroucke-Grauls CM, Meester MH, Verbrugh HA: Risk and outcome of nosocomial Staphylococcus aureus bacteraemia in nasal carriers versus non-carriers. Lancet 2004;364:703-705.
  6. Davis KA, Stewart JJ, Crouch HK, Florez CE, Hospenthal DR: Methicillin-resistant Staphylococcus aureus (MRSA) nares colonization at hospital admission and its effect on subsequent MRSA infection. Clin Infect Dis 2004;39:776-782.
  7. Pujol M, Pena C, Pallares R, Ariza J, Ayats J, Dominguez MA, Gudiol F: Nosocomial Staphylococcus aureus bacteremia among nasal carriers of methicillin-resistant and methicillin-susceptible strains. Am J Med 1996;100:509-516.
  8. Mongkolrattanothai K, Mankin P, Cranston J, Gray BM: Molecular surveillance of Staphylococcus aureus colonization in a neonatal intensive care unit. Am J Infect Control 2010;38:660-663.
  9. Maraqa NF, Aigbivbalu L, Masnita-Iusan C, Wludyka P, Shareef Z, Bailey C, Rathore MH: Prevalence of and risk factors for methicillin-resistant Staphylococcus aureus colonization and infection among infants at a level III neonatal intensive care unit. Am J Infect Control 2011;39:35-41.
  10. Wu JH, Chen CY, Tsao PN, Hsieh WS, Chou HC: Neonatal sepsis: a 6-year analysis in a neonatal care unit in Taiwan. Pediatr Neonatol 2009;50:88-95.
  11. Ho TS, Wang SM, Wu YH, Shen CF, Lin YJ, Lin CH, Liu CC: Long-term characteristics of healthcare-associated infections in a neonatal intensive care unit. J Microbiol Immunol Infect 2010;43:407-415.
  12. Huang YC, Lien RI, Su LH, Chou YH, Lin TY: Successful control of methicillin-resistant Staphylococcus aureus in endemic neonatal intensive care units - a 7-year campaign. PLoS One 2011;6:e23001.
  13. Huang YC, Su LH, Wu TL, Lin TY: Molecular surveillance of methicillin-resistant Staphylococcus aureus in neonatal intensive care units. Infect Control Hosp Epidemiol 2005;26:157-160.
  14. Huang YC, Su LH, Wu TL, Liu CE, Young TG, Chen PY, Hseuh PR, Lin TY: Molecular epidemiology of clinical isolates of methicillin-resistant Staphylococcus aureus in Taiwan. J Clin Microbiol 2004;42:307-310.
  15. Chen CJ, Su LH, Chiu CH, Lin TY, Wong KS, Chen YY, Huang YC: Clinical features and molecular characteristics of invasive community-acquired methicillin-resistant Staphylococcus aureus infections in Taiwanese children. Diagn Microbiol Infect Dis 2007;59:287-293.
  16. Huang YC, Ho CF, Chen CJ, Su LH, Lin TY: Nasal carriage of methicillin-resistant Staphylococcus aureus in household contacts of children with community-acquired diseases in Taiwan. Pediatr Infect Dis J 2007;26:1066-1068.
  17. Huang YC, Hwang KP, Chen PY, Chen CJ, Lin TY: Prevalence of methicillin-resistant Staphylococcus aureus nasal colonization among Taiwanese children in 2005 and 2006. J Clin Microbiol 2007;45:3992-3995.
  18. Enright MC, Day NP, Davies CE, Peacock SJ, Spratt BG: Multilocus sequence typing for characterization of methicillin-resistant and methicillin-susceptible clones of Staphylococcus aureus. J Clin Microbiol 2000;38:1008-1015.

    External Resources

  19. Gregory ML, Eichenwald EC, Puopolo KM: Seven-year experience with a surveillance program to reduce methicillin-resistant Staphylococcus aureus colonization in a neonatal intensive care unit. Pediatrics 2009;123:e790-e796.
  20. Bratu S, Eramo A, Kopec R, Coughlin E, Ghitan M, Yost R, Chapnick EK, Landman D, Quale J: Community-associated methicillin-resistant Staphylococcus aureus in hospital nursery and maternity units. Emerg Infect Dis 2005;11:808-813.
  21. Huang YC, Su LH, Wu TL, Lin TY: Changing molecular epidemiology of methicillin-resistant Staphylococcus aureus bloodstream isolates from a teaching hospital in Northern Taiwan. J Clin Microbiol 2006;44:2268-2270.
  22. Huang YC, Su LH, Chen CJ, Lin TY: Nasal carriage of methicillin-resistant Staphylococcus aureus in school children without identifiable risk factors in northern Taiwan. Pediatr Infect Dis J 2005;24:276-278.
  23. Huang YC, Chao AS, Chang SD, Chen YJ, Peng MT, Sung JH, Chen CJ: Association of Staphylococcus aureus colonization in parturient mothers and their babies. Pediatr Infect Dis J 2009;28:742-744.
  24. Huang YC, Chao AS, Su LH, Chang SD: A cluster of methicillin-sensitive Staphylococcus aureus colonization in a nursery. J Perinat Med 2012;40:307-310.
  25. Gerber SI, Jones RC, Scott MV, Price JS, Dworkin MS, Filippell MB, Rearick T, Pur SL, McAuley JB, Lavin MA, Welbel SF, Garcia-Houchins S, Bova JL, Weber SG, Arnow PM, Englund JA, Gavin PJ, Fisher AG, Thomson RB, Vescio T, Chou T, Johnson DC, Fry MB, Molloy AH, Bardowski L, Noskin GA: Management of outbreaks of methicillin-resistant Staphylococcus aureus infection in the neonatal intensive care unit: a consensus statement. Infect Control Hosp Epidemiol 2006;27:139-145.

Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50