A groundbreaking study, led by researchers from Children's Hospital of Philadelphia (CHOP) and the University of Pennsylvania School of Medicine (Penn Medicine), has shed light on the battle against Staphylococcus aureus, commonly known as staph, in neonatal intensive care units (NICUs). This research, published in Nature Communications, offers a crucial roadmap for precision surveillance and infection control strategies in these vulnerable environments.
The Silent Threat: Staph Infections in NICUs
Staphylococcus aureus, a bacterium often residing on the skin and in the noses of healthy individuals, can turn into a formidable adversary, causing a spectrum of infections from mild skin issues to severe bloodstream infections and pneumonia. A recent study revealed a startling statistic: one in four healthcare-acquired infections in very preterm infants in the U.S. can be attributed to staph.
Unraveling the Mystery of Staph Transmission
As part of a bi-monthly surveillance program at CHOP, led by co-lead author Dr. Lakshmi Srinivasan, nurses routinely swab the noses of babies in the NICU to detect staph. However, the lack of standardized approaches for NICU surveillance and evidence-based guidelines for testing frequency and patient monitoring has been a challenge.
Dr. Joseph Zackular, co-senior study author and researcher at CHOP's Department of Pathology and Laboratory Medicine, emphasizes the critical nature of staph as a human pathogen and a major cause of severe infections in high-risk infants. He highlights the collaborative effort between basic researchers, clinicians, and computational biologists to tackle this complex issue.
Precision Surveillance: Uncovering Staph Transmission Patterns
Utilizing the expertise within CHOP's NICU, the Center for Microbial Medicine, the Infectious Disease Diagnostics Laboratory, and the Microbiome Sequencing Center, researchers conducted precision surveillance of invasive staph infections in high-risk infants. Over three years, whole-genome sequencing revealed that shared spaces and physical proximity played significant roles in staph transmission. Stable colonization by two types of staph, MSSA and MRSA, occurred across all areas within the NICU. An analysis of over 1,000 staph genomes uncovered strain-specific persistence and colonization patterns, with MSSA causing more colonization and invasive disease than MRSA.
A New Approach to Prevention
Co-senior study author Dr. Ahmed M. Moustafa, a researcher in the Division of Gastroenterology, Hepatology and Nutrition and Co-Director of the Center for Microbial Medicine at CHOP, explains the significance of their findings: "Our study demonstrated that certain strains of staph pose a greater risk due to their higher transmissibility and potential invasiveness. This suggests that a more targeted prevention strategy, focusing on the strains causing the most infections, could be more effective."
Co-senior study author Dr. Paul J. Planet, an attending physician in the Division of Infectious Diseases at CHOP and Co-Director of the Center for Microbial Medicine, adds: "This study paves the way for real-time interventions and improved surveillance. We hope these strategies can be implemented nationwide, enhancing the health and safety of preterm infants."
A Legacy of Pediatric Care
Children's Hospital of Philadelphia, a nonprofit organization founded in 1855 as the nation's first pediatric hospital, has a long-standing commitment to exceptional patient care, training healthcare professionals, and pioneering research initiatives. Its pediatric research program is among the largest in the country, and its CHOP Care Network provides advanced pediatric care across Pennsylvania and New Jersey.
This study was supported by the Center for Microbial Medicine at Children's Hospital of Philadelphia and National Institutes of Health grant 1R01AI185544.
