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Vol. 105, No. 2, 2014
Issue release date: February 2014
Section title: Original Paper
Neonatology 2014;105:142-148
(DOI:10.1159/000356733)

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

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 5/13/2013 4:25:33 PM
Accepted: 10/10/2013
Published online: 12/18/2013

Number of Print Pages: 7
Number of Figures: 1
Number of Tables: 4

ISSN: 1661-7800 (Print)
eISSN: 1661-7819 (Online)

For additional information: http://www.karger.com/NEO

Abstract

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.


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 5/13/2013 4:25:33 PM
Accepted: 10/10/2013
Published online: 12/18/2013

Number of Print Pages: 7
Number of Figures: 1
Number of Tables: 4

ISSN: 1661-7800 (Print)
eISSN: 1661-7819 (Online)

For additional information: http://www.karger.com/NEO


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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.
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    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.
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  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.