Molecular epidemiology as an effective tool in the surveillance of infections in the neonatal intensive care unit

Objectives: nosocomial infections result in considerable morbidity and mort ality in Neonatal Intensive Care Units (NICUs). The aim of this study was t o investigate the usefulness of the molecular epidemiology approach in the surveillance and control of infections in the NICU. Methods: a 1-year prospective surveillance of nosocomial infections in a NI CU was performed using traditional epidemiological methods as well as molec ular typing of micro-organisms. Results: the nosocomial infection rate among the 347 newborns was 24.8%. Th e risk of infection was associated with low birth weight, prolonged length of stay, empiric antibiotic treatment and nasopharyngeal colonization, Four pathogens (Klebsiella pneumoniae, methicillin-resistant Staphylococcus aur eus (MRSA), methicillin-resistant Staphylococcus epidermidis (MRSE) and met hicillin-sensitive Staphylococcus aureus (MSSA) were responsible for more t han 80% of the infections, Extended-spectrum beta-lactamase-producing (ESBL ) K. pneumoniae and MRSA infections constituted outbreaks caused by a singl e clone, whereas MRSE: and MSSA infections did not represent outbreaks but rather a series of sporadic infections caused by different strains, Conclusions: molecular epidemiology techniques are powerful tools that can elucidate modes of spread and reservoirs of infection in the NICU and ident ify effective measures to control epidemic or endemic situations.