Methods: HA- MRSA transmissions were identified through review of clinical cultures and weekly surveillance cultures 8/2009 to 4/2015. Invasive SA infections included patients with MSSA or MRSA isolated from blood or CSF after admission. Starting in 12/ 2013, all NICU infants without a medical contraindication received monthly applications of MP (anterior nares and perirectal area twice daily for 5 days). Infants could be treated more than once. Rate of infections and transmission pre- and post- MP was evaluated by interrupted time-series analysis (n=174,443 patient-days). Temporal changes in both rates were examined using mixed-effects segmented linear regression.
Results: The rate of HA-associated MRSA transmissions significantly decreased from 23.1 events (95% CI, 11.8-41.2) per 10,000 patient-days to 13.2 events (95% 6.9-26.0) per 10,000 patient days (p=0.018), representing a 43% reduction, after the monthly MP was initiated. The rate of invasive infection significantly decreased from 3.0 infections (95% CI 1.8-7.2) per 10,000 patient-days to 0.8 infections (95% CI 0.3-1.5) per 10,000 patient days (p=0.032), representing a 73% reduction. Two of 4 infants who developed invasive infection in the post-intervention period had received ≥1 MP application.
Conclusion: Monthly MP was associated with decreased rates of MRSA transmission and invasive staphylococcal infections. This strategy deserves further evaluation as part of a comprehensive strategy to eliminate HAIs in NICUs.
L. Boland, None
C. Espinosa, None
J. Myers, None