Discovery on new method to better protect babies in ICU from parental bacteria

PTI, Jan 1, 2020, 3:00 PM IST

Washington: Scientists have developed and tested a novel strategy for reducing the chances of parents exposing their babies in the extensive care of hospitals to potentially deadly bacteria.

For sick or prematurely born babies spending their first days of life in a hospital’s neonatal intensive care unit (NICU), the presence of a parent can have a positive impact.

However, there is also the risk that parents may infect the baby with one of the most commonly diagnosed and potentially deadly microbial scourges in a hospital: Staphylococcus aureus, according to the study published in the Journal of the American Medical Association (JAMA).

“Traditional procedures for preventing hospital-acquired Staph infections in the NICU have primarily focused on keeping staff and facilities as sterile as possible,” said Aaron Milstone, a professor at the Johns Hopkins University School of Medicine 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 said in a statement.

According to the US Centers for Disease Control and Prevention, an estimated 30 percent of the adult population are long-term carriers of Staphylococcus aureus bacteria, the researchers said.

Most of the time, these people are healthy and the microorganisms they harbor cause no harm, they said.

However, in healthcare settings where patients may have weakened immune systems, the bacteria can become a serious, even deadly, threat.

An unchecked spread of the bacteria both the antibiotic-susceptible and antibiotic-resistant, such as methicillin-resistant Staphylococcus aureus, or MRSA, strains can lead to severe complications, including blood infections, pneumonia, heart valve infection, and bone infection.

In the NICU, S. aureus infections not only threaten a sick or premature infant’s survival but their neurological development as well, the researchers said.

To reduce the spread of S. 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 2 percent chlorhexidine gluconate, an antiseptic widely used on patients to remove surface bacteria around a surgical site before an operation.

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

Each of the infants had at least one parent who tested positive for S. aureus 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 — hands, arms, legs, chest, neck, back and the skin between the buttocks and groin — 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 S. aureus 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 percent, 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, the researchers said.

Of the 101 babies with parents in the control group, 29 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.