Surveillance for Colonization, Transmission, and Infection With Methicillin-Susceptible Staphylococcus aureus in a Neonatal Intensive Care Unit.

Importance Staphylococcus aureusis one of the leading causes of infections in neonatal intensive care units (NICUs). Most studies in this patient group focus on methicillin-resistantS aureusor the outbreak setting, whereas data for methicillin-susceptibleS aureusare limited. Objectives To identify risk factors forS aureuscolonization and infections in hospitalized newborns and to investigateS aureustransmission and its dynamics in a nonoutbreak setting. Design, Setting, and Participants This monocentric cohort study in a tertiary NICU in Heidelberg, Germany, enrolled all hospitalized neonates (n = 590) with at least 1 nasal screening swab positive forS aureus. Data were collected from January 1, 2018, to December 31, 2019. Exposures Weekly screening forS aureuscolonization was performed for all newborns until discharge. Main Outcomes and Measures The primary end point was anyS aureusinfection until hospital discharge. Transmission ofS aureusand performance of routine typing to detect transmissions were defined as the secondary outcomes of the study. Results In total, 590 newborns were enrolled (276 [46.8%] female and 314 [53.2%] male; 220 [37.3%] with birthweight Conclusions and Relevance The findings of this cohort study suggest that nasal colonization is a relevant risk factor forS aureusinfection in a nonoutbreak NICU setting. In colonized newborns, infection and colonization isolates were genetically identical, suggesting that eradication of colonization may be a useful measure to prevent infection. Further investigations are necessary to validate and assess the generalizability of our findings.