Borderline oxacillin-resistant Staphylococcus aureus carriage among healthcare workers at neonatal intensive care unit and paediatric ward.
Carrier State
/ epidemiology
Cross Infection
/ prevention & control
Drug Resistance, Bacterial
Health Personnel
Humans
Infant, Newborn
Intensive Care Units, Neonatal
Methicillin-Resistant Staphylococcus aureus
/ genetics
Multilocus Sequence Typing
Oxacillin
Prospective Studies
Staphylococcal Infections
/ epidemiology
Staphylococcus aureus
/ drug effects
Antimicrobial resistance
BORSA
Core genome multi-locus sequence typing
Infection control
Neonatal intensive care unit
Staphylococcus aureus
Whole-genome sequencing
Journal
The Journal of hospital infection
ISSN: 1532-2939
Titre abrégé: J Hosp Infect
Pays: England
ID NLM: 8007166
Informations de publication
Date de publication:
Feb 2021
Feb 2021
Historique:
received:
23
07
2020
revised:
19
11
2020
accepted:
20
11
2020
pubmed:
28
11
2020
medline:
17
7
2021
entrez:
27
11
2020
Statut:
ppublish
Résumé
During a meticillin-resistant Staphylococcus aureus contact tracing and screening investigation, two borderline oxacillin-resistant Staphylococcus aureus (BORSA)-positive screening cultures were encountered among neonatal intensive care unit (NICU) healthcare workers (HCWs). This finding led to further investigations. To assess the likelihood of an outbreak with direct transmission among HCWs. An infection control team was initiated after the discovery. The team initiated additional infection control measures and evaluated new findings. All NICUs and paediatric ward HCWs were screened for BORSA carriage, and a prospective BORSA seven-week monitoring period for patients was observed. To assess the likelihood of an outbreak with direct transmission among HCWs, the BORSA isolates were analysed using augmented fragment length polymorphism and whole-genome sequencing (WGS). Positive HCWs were prohibited from clinical work while awaiting the results from the screening programme. In all, 127 NICU and 77 general paediatric ward HCWs were screened for BORSA carriage; five HCWs were BORSA positive. Seventy-two patients were screened during the seven-week period yielding a total of 138 cultures, ranging from one to nine cultures per patient. No spread from HCWs to patients occurred, and the BORSA screening programme was discontinued. WGS analysis with core genome multi-locus sequence typing of all five BORSA strains showed relatedness between two NICU strains. During a seven-week period, no transmission from BORSA-positive HCWs to neonates was observed in either screening or clinical cultures. More vigilance and experience is needed to design adequate evidence-based interventions in the future for this vulnerable population.
Sections du résumé
BACKGROUND
BACKGROUND
During a meticillin-resistant Staphylococcus aureus contact tracing and screening investigation, two borderline oxacillin-resistant Staphylococcus aureus (BORSA)-positive screening cultures were encountered among neonatal intensive care unit (NICU) healthcare workers (HCWs). This finding led to further investigations.
AIM
OBJECTIVE
To assess the likelihood of an outbreak with direct transmission among HCWs.
METHODS
METHODS
An infection control team was initiated after the discovery. The team initiated additional infection control measures and evaluated new findings. All NICUs and paediatric ward HCWs were screened for BORSA carriage, and a prospective BORSA seven-week monitoring period for patients was observed. To assess the likelihood of an outbreak with direct transmission among HCWs, the BORSA isolates were analysed using augmented fragment length polymorphism and whole-genome sequencing (WGS).
FINDINGS
RESULTS
Positive HCWs were prohibited from clinical work while awaiting the results from the screening programme. In all, 127 NICU and 77 general paediatric ward HCWs were screened for BORSA carriage; five HCWs were BORSA positive. Seventy-two patients were screened during the seven-week period yielding a total of 138 cultures, ranging from one to nine cultures per patient. No spread from HCWs to patients occurred, and the BORSA screening programme was discontinued. WGS analysis with core genome multi-locus sequence typing of all five BORSA strains showed relatedness between two NICU strains.
CONCLUSION
CONCLUSIONS
During a seven-week period, no transmission from BORSA-positive HCWs to neonates was observed in either screening or clinical cultures. More vigilance and experience is needed to design adequate evidence-based interventions in the future for this vulnerable population.
Identifiants
pubmed: 33245996
pii: S0195-6701(20)30541-7
doi: 10.1016/j.jhin.2020.11.017
pii:
doi:
Substances chimiques
Oxacillin
UH95VD7V76
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
104-108Informations de copyright
Copyright © 2020. Published by Elsevier Ltd.