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Risk factors associated with complicated methicillin-resistant Staphylococcus aureus bacteremia in neonates

Korean Journal of Pediatrics 2010;53(2):173-177.
Published online February 15, 2010.
Risk factors associated with complicated methicillin-resistant Staphylococcus aureus bacteremia in neonates
Young Jin Lee1, Hyen Jin Kim2, Shin Yun Byun1, Su Eun Park1, Hee Ju Park1
1Department of Pediatrics, School of Medicine, Pusan National University, Yangsan, Korea
2School of Medicine, Pusan National University
신생아의 MRSA 균혈증에서 합병증 발생과 연관된 위험인자
이영진1, 김현진2, 변신연1, 박수은1, 박희주1
1부산대학교 의학전문대학원 소아과학교실
2부산대학교 의학전문대학원
Correspondence: 
Shin Yun Byun, Tel: +82.55-360-3156, Fax: +82.55-360-2181, Email: byun410@hanmail.net
Abstract
Purpose
: Methicillin-resistant Staphylococcus aureus (MRSA) is an important pathogen that causes nosocomial infection in NICU. It contributes to neonatal morbidity and mortality with variable complications. This study was conducted to identify the risk factors associated with complicated MRSA bacteremia in neonates.
Methods
: We reviewed the medical records of 44 neonates with positive blood culture for MRSA who were admitted to the NICU of Pusan National University Hospital from January 2002 to December 2007. We compared various factors of the complicated and uncomplicated MRSA bacteremia cases.
Results
: Of the 44 neonates, 31 were male and 13, female. The mean gestational age and birth weight were 33.2¡¾4.9 weeks and 1,859.9¡¾962.2 g, respectively. Twenty-one of infants were treated with a mechanical ventilator during a mean of 8.8¡¾13.8 days. There were 13 cases of complicated and 31 cases of uncomplicated MRSA bacteremia. Between the 2 groups, we compared the following variables: gestational age, birth weight, ventilator use, umbilical catheter use and central catheter insertion, O2 inhalation, first oral feeding day after birth, underlying disease, transfusion, and initial vancomycin use. The underlying disease and transfusion were the risk factors related to complicated MRSA bacteremia.
Conclusion
: Complicated MRSA bacteremia is related to underlying disease and transfusion. Since this was a retrospective study with a small sample size, it offered limited capacity to compare complicated and uncomplicated MRSA bacteremia. A prospective study with a larger population is needed to determine the exact characteristics of MRSA bacteremia in NICU.
Key Words: MRSA, Complication, Risk factor, Vancomycin


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