Surveillance of Staphylococci Presence in and Around Neonate Isolette Beds in a Neonatal Intensive Care Unit of a Children's Hospital

Abstract

Background Neonates in a neonatal intensive care unit (NICU) represent patients vulnerable to many pathogens due to their immunocompromised status. An earlier study of Staphylococci in this NICU suggested widespread environmental contamination, including Methicillin Resistant Staphylococcus aureus (MRSA). This study focused on Staphylococci associated with occupied isolette beds in the unit. Methods Two phases of this study were conducted. Initially, sterile transport swabs were used to collect samples from 10 different locations in 7 different pods of a NICU on 9 dates, focusing on areas surrounding neonate isolette beds. The second phase involved collection of swabs from 10 different locations in and on occupied neonate isolette beds, on 5 dates. For both phases swabs were used to inoculate Hardy CHROM MRSA agar plates (to detect MRSA), and mannitol salt agar (to detect S. aureus). Incubation was at 37°C for 48 hours. Descriptive statistics and Mann Whitney Utest was used for analysis. Results Results of phase one indicated that the floors by the pod sinks were most contaminated (p < .05) by MRSA and S. aureus (% positive swabs, MRSA = 76.2%; S. aureus = 87.3%). Looking more closely at the isolettes in phase two, we found MRSA present at the foot of the bed (11.4%), in ports at the foot of the beds (5.7%), and on suction tips (25.7%). Conclusions These data suggest that after efforts to reduce bacterial contamination in this NICU, focused on care-giver:patient contacts, several key environments near isolettes remain contaminated by Staphylococci. The floors in the unit may serve as a reservoir for MRSA and S. aureus. More concerning are the high levels of MRSA contamination found in the suction devices often found adjacent to or inside isolettes. Additional measures to target Staphylococci reduction in this NICU are now underway. Neonates in a neonatal intensive care unit (NICU) represent patients vulnerable to many pathogens due to their immunocompromised status. An earlier study of Staphylococci in this NICU suggested widespread environmental contamination, including Methicillin Resistant Staphylococcus aureus (MRSA). This study focused on Staphylococci associated with occupied isolette beds in the unit. Two phases of this study were conducted. Initially, sterile transport swabs were used to collect samples from 10 different locations in 7 different pods of a NICU on 9 dates, focusing on areas surrounding neonate isolette beds. The second phase involved collection of swabs from 10 different locations in and on occupied neonate isolette beds, on 5 dates. For both phases swabs were used to inoculate Hardy CHROM MRSA agar plates (to detect MRSA), and mannitol salt agar (to detect S. aureus). Incubation was at 37°C for 48 hours. Descriptive statistics and Mann Whitney Utest was used for analysis. Results of phase one indicated that the floors by the pod sinks were most contaminated (p < .05) by MRSA and S. aureus (% positive swabs, MRSA = 76.2%; S. aureus = 87.3%). Looking more closely at the isolettes in phase two, we found MRSA present at the foot of the bed (11.4%), in ports at the foot of the beds (5.7%), and on suction tips (25.7%). These data suggest that after efforts to reduce bacterial contamination in this NICU, focused on care-giver:patient contacts, several key environments near isolettes remain contaminated by Staphylococci. The floors in the unit may serve as a reservoir for MRSA and S. aureus. More concerning are the high levels of MRSA contamination found in the suction devices often found adjacent to or inside isolettes. Additional measures to target Staphylococci reduction in this NICU are now underway.