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249 Colonization/Infection with Methicillin-resistant Staphylococcus aureus Among Patients and Their Contacts at a Tertiary Care Children's Hospital in the Midwest

Saturday, April 2, 2011
Trinity Ballroom (Hilton Anatole)
Archana Chatterjee, MD, PhD , Creighton University, Omaha, NE
Mel Hall , Children's Hospital and Medical Center, Omaha, NE
Sharon Plummer, RN, BS, CIC , Children's Hospital and Medical Center, Omaha, NE
Brenda Heybrock, RN, CIC , Children's Hospital and Medical Center, Omaha, NE
Lindsey Hegemann, BSN, RN, CPN , Children's Hospital and Medical Center, Omaha, NE
Kari Simonsen, MD , University of Nebraska Medical Center, Omaha, NE
Background:

Children are particularly at risk for colonization/infection with methicillin-resistant Staphylococcus aureus (MRSA). Once admitted to the hospital they should be isolated to prevent nosocomial spread of this organism.  At Children’s Hospital and Medical Center (CHMC) in Omaha, NE, the infection prevention policy is to identify and isolate children who are colonized/infected with MRSA.  A history of exposure to household contacts with MRSA is also used to make decisions regarding isolation. 

Objective: To measure the changing rates of MRSA colonization/infection among patients and their contacts presenting to CHMC in 2008-2009 compared to 2007.

Methods:

Data were collected through a Quality Improvement project.  The Infection Prevention database was scanned for all children presenting with a history of or contact with MRSA infection/colonization 1/1/2008-12/31/2009 and compared to 2007.  Family groups with MRSA were identified, and patient medical records were reviewed for reports of household contacts with MRSA.

Results:

Identification of MRSA colonization/infection in patients at CHMC has steadily increased from 701 in 2007 to 1,012 in 2008 and 1,337 in 2009.  In 2008-2009, 58 family groups with 132 children were identified as having at least one known MRSA positive member. During this time, there were 42 hospital admissions of MRSA colonized/infected children from these 58 families.  Additionally, there were 8 admissions involving 6 children within the 58 family groups without known personal prior MRSA colonization/infection, only household exposure.    MRSA surveillance among the 58 family groups revealed 60% had at least one additional family member with laboratory-confirmed colonization/infection.  Of the 132 children, 73% had laboratory-confirmed MRSA colonization/infection (58 patients + 38 siblings).

Conclusions:

MRSA colonization/infection continues to increase at CHMC.  Children who develop MRSA colonization/infection frequently have a household contact who is also colonized/ infected.  We speculate that identifying household contacts and appropriately isolating these patients may reduce the transmission of MRSA in the hospital.