Key Points
- S. aureus is a clinically important pathogen for NICU infants.
- Estimated incidence of S. aureus infection is up to 45 per 10,000 hospitalized infants.
- Neonates may acquire S. aureus as part of their normal developing microbiota, yet colonization predisposes to invasive infection.
Considerations
Family Members and Visitors
- Emphasize the importance of hand hygiene by all family members and visitors in preventing the transmission of organisms
- Consistently model proper hand hygiene
- Require all family members and visitors to perform proper hand hygiene when:
- Entering and exiting the NICU
- Before and after each contact with the infant(s)
- Encourage and promote skin-to-skin care and breastfeeding, despite the parent or infant’s MRSA infection or colonization status
- When an infant or parent is colonized with MRSA, family members and visitors are not required to use PPE while caring for their infant(s)
- When a parent has active MRSA infection:
- Encourage skin-to-skin care and breastfeeding, while taking into consideration the location of the parent’s MRSA lesion, the ability to control drainage, and the likelihood of the infant’s contact with the lesion
- Do not require the parent to wear a gown or gloves if drainage is contained, the site of the infection is covered, and strict hand hygiene practices are followed
- Consider routine screening of infant(s), e.g. weekly if parents have active MRSA infections
Multiple Gestations with Discordant MRSA Status
- Use contact isolation for MRSA-colonized infants. Consider contact precautions for the non-colonized infant(s).
- Encourage skin-to-skin care to promote parent–infant bonding. Emphasize hand hygiene to prevent organism transfer to the non-colonized infant(s).
- Consider having parents perform skin-to-skin care with the non-colonized infant prior to skin-to-skin care with the MRSA-colonized infant.
- Encourage breastfeeding regardless of an infant’s MRSA status.
- Units:
- Should strongly consider routine screening of non-colonized infants (e.g., weekly, biweekly) with MRSA-colonized or infected siblings in the NICU.
