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

J Perinatol. 2021 Jun;41(6):1285-1292. doi: 10.1038/s41372-021-00944-8. Epub 2021 Mar 1.


Objective: 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).

Study design: 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.

Results: 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.

Conclusion: Progression from MRSA colonization to symptomatic infection is associated with increased morbidity and may be mitigated through decolonization.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Case-Control Studies
  • Child
  • Critical Illness
  • Humans
  • Infant, Newborn
  • Methicillin-Resistant Staphylococcus aureus*