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Background  Once present in a neonatal intensive care unit (NICU), multidrug resistant  Staphylococcus capitis  NRCS-A is able to settle and diffuse.    Objective  The objective of this study was to evaluate the impact of infection control (IC) interventions to reduce the spread of  Staphylococcus capitis  NRCS-A in a NICU.    Methods  Between December 2012 and December 2017, all patients presenting positive sampling (blood, skin or catheter) to  S. capitis  were included, and clinical data were recorded from electronic clinical charts. The IC team has continually implemented measures of control infections (hand hygiene, standard precautions, patient contact isolation and disinfection of the inanimate environment). From May 2015, a steam cleaner was implemented in the cleaning procedure instead of disinfectant to disinfect heating tables and incubators. Four periods were determined: Period 1 (P1) before steam cleaner acquisition; Period 2 (P2) after implementation steam cleaner; Period 3 (P3) when the steam cleaner had broken down, and Period 4 (P4) when the steam cleaner was functional again. The consumption of antibiotics and the epidemiology of infections inside the NICU were investigated during the study period.    Results  During the studied period, 37 infants were infected or colonized by  S. capitis . The incidences of infection or colonization by  S. capitis  were P1 = 1.04‰, P2 = 0.55‰, P3 = 3.95 ‰ and P4 = 0‰ and were significantly different between P1-P3 and P2-P4 ( p  < 0.001). During the different periods, antibiotics consumption and bacterial epidemiology of the ward were stable.    Conclusions  The use of steam vapor system was associated with a significantly decreased incidence of  S. capitis  NRCS-A infection or colonization and could constitute an effective and safe procedure to control and eradicate its diffusion inside NICUs.

antimicrobial resistance and infection control

Successful implementation of infection control measure in a neonatal intensive care unit to combat the spread of pathogenic multidrug resistant Staphylococcus capitis