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Prevalence of MRSA Colonization among Neonatal and Pediatric ICU Patients in Chicago

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posted on 21.07.2015, 00:00 authored by Rosie D. Lyles
Background: Beginning October 2007, the MRSA Screening and Reporting Act (210 ILCS 83/) mandated active surveillance for all ICU patients in Illinois, with isolation of MRSA-colonized patients. We assessed MRSA colonization prevalence among neonatal (NICU) and pediatric (PICU) patients using a series of point prevalence surveys. Methods: Chicago hospitals with NICU or PICU patients were recruited for 6 single-day point prevalence surveys (PPSs) approximately 6 months apart from June 2008 to July 2011. After 2011, yearly surveys were obtained in 2012 and 2013. All ICU patients were cultured for MRSA (nose and umbilicus for neonates; nose and groin for pediatric patients) using a single swab for each body site. Hospital-reported admission screen results (i.e. 210 ILCS 83/-mandated) were also obtained. Point prevalence cultures were screened for MRSA using broth enrichment, chromogenic agar, and standard confirmatory methods. Results: All eligible hospitals (N=10) participated (10 NICUs and 6 PICUs) with 99.6% of NICU and 93% of PICU eligible patients cultured across PPSs. Hospital-reported adherence to admission screens mandated by 210 ILCS 83/ was high (99.6% for NICU and 93.3% for PICU). Overall MRSA prevalence by PPSs in NICUs was 4.2% (89/2101); PICU, 5.7% (36/632). MRSA colonization prevalence declined in NICUs (estimated yearly odds ratio [OR], 0.92, 95% confidence interval [CI] 0.77 to 1.11, P<0.39) but not in PICUs (OR 1.25, 95% CI 1.10 to 1.42, P<0.001). Conclusion: In the time period following implementation of mandatory active surveillance, we found MRSA colonization in a proportion of NICU and PICU patients, with evidence of on-going MRSA transmission.

History

Advisor

Zwanziger, Jack

Department

Health Policy and Administration Division

Degree Grantor

University of Illinois at Chicago

Degree Level

Masters

Committee Member

Lin, Michael Trick, William E.

Submitted date

2015-05

Language

en

Issue date

21/07/2015

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