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Am J Infect Control. 2017 Dec 1;45(12):1388-1393. doi: 10.1016/j.ajic.2017.06.021.

Risk factors for methicillin-resistant Staphylococcus aureus colonization in the neonatal intensive care unit: A systematic review and meta-analysis.

Author information

1
Department of Pediatrics, Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, OH. Electronic address: Matthew.Washam@cchmc.org.
2
Department of Pediatrics, Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.

Abstract

CONTEXT:

Methicillin-resistant Staphylococcus aureus (MRSA) causes a significant burden of illness in neonatal intensive care units (NICUs) worldwide. Identifying infants colonized with MRSA has become an important infection control strategy to interrupt nosocomial transmission.

OBJECTIVE:

Assess risk factors for MRSA colonization in NICUs via a systematic review and meta-analysis.

DATA SOURCES:

MEDLINE, Embase, Web of Science, and The Cochrane Library databases were searched from inception through September 2015.

STUDY SELECTION:

Studies reporting risk factors for MRSA colonization using noncolonized controls in subspecialty level III or IV NICUs were included.

DATA EXTRACTION:

Two authors independently extracted data on MRSA colonization risk factors, study design, and MRSA screening methodology.

RESULTS:

Eleven articles were included in the systematic review, with 10 articles analyzed via meta-analysis. MRSA colonization was associated with gestational age <32 weeks (odds ratio [OR], 2.67; 95% confidence interval [CI], 1.35-5.27; P = .01) and birth weight <1,500 g (OR, 2.63; 95% CI, 1.25-5.55; P = .01). Infant sex (P = .21), race (P = .06), inborn status (P = .09), and delivery type (P = .24) were not significantly associated with colonization.

CONCLUSIONS:

Very preterm and very-low birth weight infants were identified as having an increased risk for MRSA colonization on meta-analysis. Multifaceted infection prevention strategies should target these high-risk infants to reduce MRSA colonization rates in NICUs.

KEYWORDS:

Colonization; Epidemiology; MRSA; NICU; Risk factors

PMID:
29195583
DOI:
10.1016/j.ajic.2017.06.021
[Indexed for MEDLINE]

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