Healthy Living: Local News
Staph infections plague Providence infant care unit
Story Updated: Jun 3, 2011
Providence Alaska Medical Center is dealing with a serious outbreak of a drug-resistant staph infection among some of its most vulnerable patients, babies in the newborn intensive care unit.
Fourteen babies since March have contracted mild to moderate infections caused by MRSA, Methicillin-resistant Staphylococcus Aureus, a state health department epidemiologist said Wednesday. Seventeen other infants have been found carrying the bacteria on their skin or noses, but did not get sick from it, said Kim Porter, a state epidemiology expert. "We don't have any active infections, but we still have those patients (some of the ones carrying the bacteria)," said Dr. Lily Lou, medical director for the Providence newborn intensive care unit. "We're hoping we're in the waning phase." It's been several weeks since any new infections were discovered, said a Providence spokeswoman. Providence called in state epidemiologists in April to help stop the bacteria from spreading and possibly causing more infections. The state is still actively involved.
Bacterial infections can range from mild to life-threatening or fatal. Ones caused by MRSA are different because they resist treatment by a group of antibiotics that includes methicillin penicillin, and amoxicillin, according to the federal Centers for Disease Control and Prevention. But the infections can be treated with other antibiotics, and all the infected babies in Providence's neonatal intensive care unit have been treated successfully and are improving, said Dr. Megan Clancy, Providence's director of infection control. The symptoms for staph infections tend to be redness, pustules or boils on the skin, pain and sometime fevers, she said. It's the first time such an outbreak has occurred in the Providence newborn intensive care unit (NICU), though such outbreaks have occurred in other NICUs around the country, said Dr. Clancy. The hospital as a whole annually usually sees 10 to 12 cases of MRSA infection of the type that people get in the hospital, she said. People can also get MRSA infections just out in the community. The bacteria normally spreads by hand-to-skin contact, said Clancy. "You have it on your hands, you touch somebody else, you're involved in their care." Sneezes or coughs can also transfer the bacteria. All of the cases in the Providence NICU come from the same genetic fingerprint -- a single source, said Porter. The strain originated from within the hospital, she said. "We don't know how or when it came into the unit," said Porter. While they're still trying to figure that out, "Our priority from the beginning has been just to stop it." Providence is now taking extra precautions to make sure the bacteria doesn't spread, Dr. Clancy said. Providence has placed babies who carry the bacteria or were infected, in a separate room, with separate nursing staff and equipment, from those who are not carrying the bacteria.
The new routine for babies with the bacteria calls for staff to do 15-30 seconds of hand-washing, or use an alcohol gel; to put on gloves; and to wear a long gown with full-length sleeves, covering clothes. A nurse does all that when she enters a baby's space. She then discards the gloves and gown, and repeats the process for the next baby. Parents visiting their infants need only wash their hands properly, since they'll only be touching one baby, said Dr. Clancy. Providence also checks all infants on admission to the intensive care unit, and checks all infants in the unit weekly, for signs of the bacteria. The hospital also plans to screen health-care workers in the unit, "anyone likely to be moving from infant to infant," Clancy said. Since infants born needing intensive care often stay in the NICU for months, she expects to keep up the additional precautions for that long as well.
Porter, from the state, said she and another state worker will be actively monitoring hand hygiene practices and other control measures in the unit over the next couple of weeks at different times of the day, and will help screen health care workers. The Providence newborn intensive care unit on average cares for about 48 newborns per day, all babies who need intensive care in the immediate post-birth period, said Dr. Lou. Providence operates the only Level 3 neonatal intensive care unit -- for the most fragile newborns, including those on ventilators -- in Alaska. Providence recently won an award for work the NICU team did to eliminate blood stream infections related to catheters. The award was from the National Quality Forum and The Joint Commission, both national organizations.