EOC 74 - Keeping Our Babies Safe: Reducing Methicillin Resistant Staphylococcus aureus Incidence in an Infant Special Care Unit

Background: Infant Special Care Unit (ISCU) patients are screened for Methicillin Resistant Staphylococcus aureus (MRSA) colonization weekly due to associated morbidity and mortality in neonates. Continual efforts to reduce MRSA incidence are recommended by Centers for Disease Control and Prevention, especially in an outbreak setting.

Methods: This study took place on a 44-bed, level III ISCU in Illinois. The patients are housed in a cohorted setting, such that up to six patients share a room. In 2021, a cluster of MRSA cases necessitated an outbreak investigation. Utilizing the Plan-Do-Study-Act (PDSA) cycle, we implemented improvement strategies for hand hygiene, visitor education, and environmental cleaning. A multidisciplinary group convened between August and December 2021 to address opportunities to enhance environmental cleanliness, including institution of biannual deep cleaning of patient rooms. A second multidisciplinary group convened to optimize visitor education and staff and visitor hand hygiene between October 2021 and July 2022. Using construction, marketing, and education resources, the unit scrub-in process was standardized across all staff and visitors, and surgical hand antisepsis was employed to maximize cleanliness upon entry to the ISCU. Using both retrospective and prospective cohort study data collection, MRSA cases, as detected on weekly screens and clinical cultures, were compared pre and post intervention.

Results: Data showed an 80% decrease in the incidence of MRSA in the ISCU population, indicating the interventions were successful. In the six months preceding the intervention period, five cases of MRSA were detected. In the six months following the intervention period, one case of MRSA was detected.

Conclusions: Using the PDSA cycle to implement infection prevention strategies in the ISCU was successful at reducing the incidence of MRSA. Our results indicate the value of a multi-disciplinary and multi-faceted approach to MRSA reduction in the neonatal setting.