Methicillin-Resistant and Susceptible Staphylococcus aureus Bacteremia and Meningitis in Preterm Infants

Andi L Shane; Nellie I Hansen; Barbara J Stoll; Edward F Bell; Pablo J Sánchez; Seetha Shankaran; Abbot R Laptook; Abhik Das; Michele C Walsh; Ellen C Hale; Nancy S Newman; Stephanie J Schrag; Rosemary D Higgins; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network

doi:10.1542/peds.2011-0966

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Methicillin-Resistant and Susceptible Staphylococcus aureus Bacteremia and Meningitis in Preterm Infants

Journal article

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Methicillin-Resistant and Susceptible Staphylococcus aureus Bacteremia and Meningitis in Preterm Infants

Andi L Shane, Nellie I Hansen, Barbara J Stoll, Edward F Bell, Pablo J Sánchez, Seetha Shankaran, Abbot R Laptook, Abhik Das, Michele C Walsh, Ellen C Hale, …

Pediatrics (Evanston), Vol.129(4), pp.e914-e922

04/2012

DOI: 10.1542/peds.2011-0966

PMCID: PMC3313632

PMID: 22412036

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Abstract

BACKGROUND: Data are limited on the impact of methicillin-resistant Staphylococcus aureus (MRSA) on morbidity and mortality among very low birth weight (VLBW) infants with S aureus (SA) bacteremia and/or meningitis (B/M). METHODS: Neonatal data for VLBW infants (birth weight 401–1500 g) born January 1, 2006, to December 31, 2008, who received care at centers of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network were collected prospectively. Early-onset (≤72 hours after birth) and late-onset (>72 hours) infections were defined by blood or cerebrospinal fluid cultures and antibiotic treatment of ≥5 days (or death <5 days with intent to treat). Outcomes were compared for infants with MRSA versus methicillin-susceptible S aureus (MSSA) B/M. RESULTS: Of 8444 infants who survived >3 days, 316 (3.7%) had SA B/M. Eighty-eight had MRSA (1% of all infants, 28% of infants with SA); 228 had MSSA (2.7% of all infants, 72% of infants with SA). No infant had both MRSA and MSSA B/M. Ninety-nine percent of MRSA infections were late-onset. The percent of infants with MRSA varied by center (P < .001) with 9 of 20 centers reporting no cases. Need for mechanical ventilation, diagnosis of respiratory distress syndrome, necrotizing enterocolitis, and other morbidities did not differ between infants with MRSA and MSSA. Mortality was high with both MRSA (23 of 88, 26%) and MSSA (55 of 228, 24%). CONCLUSIONS: Few VLBW infants had SA B/M. The 1% with MRSA had morbidity and mortality rates similar to infants with MSSA. Practices should provide equal focus on prevention and management of both MRSA and MSSA infections among VLBW infants.

newborn

methicillin resistant

infant

Staphylococcus aureus

Details

Title: Subtitle: Methicillin-Resistant and Susceptible Staphylococcus aureus Bacteremia and Meningitis in Preterm Infants
Creators: Andi L Shane - Department of Pediatrics, Emory University School of Medicine, and Children’s Healthcare of Atlanta, Atlanta, Georgia
Nellie I Hansen - Statistics and Epidemiology Unit, RTI International, Research Triangle Park, North Carolina
Barbara J Stoll - Department of Pediatrics, Emory University School of Medicine, and Children’s Healthcare of Atlanta, Atlanta, Georgia
Edward F Bell - Department of Pediatrics, University of Iowa, Iowa City, Iowa
Pablo J Sánchez - Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas
Seetha Shankaran - Department of Pediatrics, Wayne State University, Detroit, Michigan
Abbot R Laptook - Department of Pediatrics, Women & Infants Hospital, Brown University, Providence, Rhode Island
Abhik Das - Statistics and Epidemiology Unit, RTI International, Rockville, Maryland
Michele C Walsh - Department of Pediatrics, Rainbow Babies & Children’s Hospital, Case Western Reserve University, Cleveland, Ohio
Ellen C Hale - Department of Pediatrics, Emory University School of Medicine, and Children’s Healthcare of Atlanta, Atlanta, Georgia
Nancy S Newman - Department of Pediatrics, Rainbow Babies & Children’s Hospital, Case Western Reserve University, Cleveland, Ohio
Stephanie J Schrag - Centers for Disease Control and Prevention, Atlanta, Georgia; and
Rosemary D Higgins - Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network
Resource Type: Journal article
Publication Details: Pediatrics (Evanston), Vol.129(4), pp.e914-e922
DOI: 10.1542/peds.2011-0966
PMID: 22412036
PMCID: PMC3313632
NLM abbreviation: Pediatrics
ISSN: 0031-4005
eISSN: 1098-4275
Publisher: American Academy of Pediatrics
Language: English
Date published: 04/2012
Academic Unit: Stead Family Department of Pediatrics; Neonatology
Record Identifier: 9984093323202771

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