Babies in ICU can be better protected from parental bacteria

New York: Researchers have developed and tested a relatively simple strategy for reducing the chance of parents exposing their babies in the NICU to one of the most commonly diagnosed and potentially deadly microbial scourges in a hospital: Staphylococcus aureus.

“Traditional procedures for preventing hospital-acquired Staph infections in the NICU have primarily focused on keeping staff and facilities as sterile as possible,” said study researcher Aaron Milstone from Johns Hopkins University in the US.

“Our study is among the first to focus on parents as a source of the bacteria and then test the effectiveness of an intervention to combat the problem,” Milstone added.

According to the researchers, Staphylococcus aureus infections in the NICU not only threaten a sick or premature infant’s survival but their neurological development as well.

In a 2015 study, Milstone and others estimated that there are more than 5,000 cases of invasive such infections each year in NICUs across the US and that 10 per cent of the children will likely die before hospital discharge.

To reduce the spread of Staphylococcus aureus, the researchers turned to a simple regimen for mothers and fathers to follow while their child is in intensive care.

The preventive measure includes the application of an antibiotic (mupirocin) ointment into the nose and skin cleansing with a wipe containing two per cent chlorhexidine gluconate, an antiseptic widely used on patients to remove surface bacteria around a surgical site before an operation.

The Treating Parents to Reduce NICU Transmission of Staphylococcus (TREAT Parents) clinical trial was conducted to test the proposed strategy’s effectiveness.

The researchers selected for study 190 newborn babies admitted to two NICUs at Johns Hopkins-affiliated hospitals in Baltimore, Maryland, between November 2014 and December 2018.

Each of the infants had at least one parent who tested positive for the bacteria when screened at the time of their child’s entry into the NICU.

Baseline S. aureus counts were done for the infants at the same time.

The parents of 89 babies self-administered the antibiotic nasal ointment twice a day for five days and cleaned designated skin areas with antiseptic wipes for the same time period.

The control group, consisting of the remaining 101 parental couples, used identically packaged placebo treatments of petroleum jelly and non-antiseptic wipes.

Both sets of babies were monitored for Staphylococcus colonization until discharge from the NICU. Bacteria recovered from the infants were analyzed to determine if they were the same strain as seen in at least one parent.

Among the 190 infants studied overall, 42, or about 22 per cent, acquired S. aureus that matched bacteria recovered from either their mother or father, or from both parents. In this group, four babies had MRSA strains acquired from a parent.

Of the 101 babies with parents in the control group, 29 per cent had parentally acquired bacteria compared with only 13 of the 89 babies whose parents were given actual antibiotic ointment and antiseptic wipes to use.

“These results from our preliminary trial indicate that treatment with intranasal mupirocin and chlorhexidine wipes may significantly reduce the number of infants in the NICU who will get S. aureus from contact with a parent,” Milstone said.


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