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Infection control practices and mrsa decolonisation in UK neonatal units
  1. S T Francis,
  2. H Khan,
  3. N L Kennea
  1. St George's Healthcare NHS Trust, Tooting, London, UK

Abstract

Prevention of nosocomial infection is a key part of good neonatal care. In particular, methicillin resistant Staphylococcus aureus (MRSA) is an important pathogen with screening for colonisation now commonplace. There appear wide variations in infection control practices in UK neonatal units.

Aims The aim of this survey was to determine the impact of infection control problems, and to evaluate the differences in infection control/hygiene practices.

Methods We undertook a structured telephone interview of all neonatal units in the UK between July 2009 and February 2010. 198 Neonatal units were identified and 172 (87%) agreed to take part.

Results 12.2% of units had been closed due to an infection control issue in the last year, of these, 48% were Level 3 units and 32% surgical units. 14.1% of units had a current infection control concern, of these, 36% were due to MRSA, 24% multi-resistant Gram negative organisms and 20% viral infections. Surgical units were more frequently affected (40% vs 11.1%). There was a wide variation in the hygiene measures utilised (e.g., surgical scrubs, aprons and gloves). There were also considerable differences in hand hygiene practices. Infants identified as colonised with MRSA were routinely decolonised in 73.8% of units. De-colonisation regimens varied with more than 15 different regimens. Degree of isolation after successful de-colonisation also varied.

Conclusions Neonatal units in the UK are faced with significant infection control issues and there are considerable variations in infection control practices. There is a need to develop an evidence base to underpin practice.

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