Abstract
Background
Both Staphylococcus aureus and coagulase negative Staphylococci are common causes of late-onset neonatal sepsis in the neonatal intensive care unit (NICU), usually relating to intravascular access device infections.
Aims
This project aimed to review the impact on antimicrobial treatment and clinical outcome in the NICU setting, of the introduction of the Xpert MRSA/SA BC test (Cepheid, USA) for the identification of staphylococci in blood cultures.
Methods
A retrospective audit was carried out of the pre- and post-intervention periods; the intervention was the introduction of the Xpert MRSA/SA BC test.
Results
In total, 88 neonates had positive blood cultures with Staphylococcus spp., comprising 42 neonates in the pre-intervention and 46 in the post-intervention groups. The pre-intervention group had a higher birth weight (1.541 kg vs. 1.219 kg, p = 0.05) and higher platelet count (288 vs. 224 × 109/L, p = 0.05). There was a trend towards a shorter duration of antimicrobial therapy in term infants and in the length of admission; however, this was not statistically significant (p = 0.2). All of the nine infants post-intervention with significant bacteraemia (S. aureus =3, CoNS =6) were changed to the optimal antimicrobial at the time the result was available.
Conclusions
This study shows that the introduction of the Xpert MRSA/SA BC test can lead to a reduction in the length of admission and duration of antimicrobials in term infants; however, the difference was not statistically significant. All nine infants with clinically significant bacteraemia were treated with the appropriate antimicrobial when the Xpert MRSA/SA BC test result was available.
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Funding
No specific funding was required for this study as it was a retrospective audit. This research involved an international collaboration between Perdana University–Royal College of Surgeons in Ireland (PU-RCSI) School of Medicine, and Research Summer School–Royal College of Surgeons in Ireland (RSS-RCSI). We would like to acknowledge the original sponsorship of the GeneXpert machine from the Dublin North East Health Service Executive SARI Committee to the Rotunda Hospital.
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The authors declare that they have no conflict of interest.
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Koh, L.L., O’Rourke, S., Brennan, M. et al. Impact of a rapid molecular test for positive blood cultures from neonatal intensive care patients on clinical management: a retrospective audit. Ir J Med Sci 187, 423–427 (2018). https://doi.org/10.1007/s11845-017-1649-1
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DOI: https://doi.org/10.1007/s11845-017-1649-1