Factors associated with progression to infection in methicillin-resistant Staphylococcus aureus-colonized, critically ill neonates

• DOI: 10.1038/s41372-021-00944-8
• Publication Date: 2021-03-01T12:04:53Z
• Authors: Carly R. Schuetz; Patrick G. Hogan; Patrick J. Reich; Sara Halili; Hannah E. Wiseman; Mary G. Boyle; Ryley M. Thompson; Barbara B. Warner; Stephanie A. Fritz
• Keywords: Methicillin-Resistant Staphylococcus aureus; 03 medical and health sciences; 0302 clinical medicine; Case-Control Studies; Critical Illness; Infant, Newborn; Humans; Child; Article; 3. Good health

To identify factors associated with development of symptomatic infection in infants colonized with methicillin-resistant Staphylococcus aureus (MRSA) in the Neonatal Intensive Care Unit (NICU).This case-control study was performed at St. Louis Children's Hospital NICU from 2009 to 2019. The MRSA-colonized infants who developed symptomatic MRSA infection (cases) were matched 1:3 with MRSA-colonized infants who did not develop infection (controls). Demographics and characteristics of NICU course were compared between groups. Longitudinal information from subsequent hospitalizations was also obtained.Forty-two infected cases were compared with 126 colonized-only controls. Cases became colonized earlier in their NICU stay, were less likely to have received mupirocin for decolonization, and had a longer course of mechanical ventilation than controls. Longitudinally, cases had a more protracted NICU course and were more likely to require hospital readmission.Progression from MRSA colonization to symptomatic infection is associated with increased morbidity and may be mitigated through decolonization.