{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T18:27:25Z","timestamp":1788460045210,"version":"build-2803163510"},"reference-count":35,"publisher":"American Society for Microbiology","issue":"8","license":[{"start":{"date-parts":[[2015,8,1]],"date-time":"2015-08-01T00:00:00Z","timestamp":1438387200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[2015,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            Methicillin-resistant\n            <jats:named-content content-type=\"genus-species\">Staphylococcus aureus<\/jats:named-content>\n            (MRSA) is a frequent source of infection in the neonatal intensive care unit (NICU), often associated with significant morbidity. Active detection and isolation (ADI) programs aim to reduce transmission. We describe a comprehensive analysis of the clinical and molecular epidemiology of MRSA in an NICU between 2003 and 2013, in the decade following the implementation of an MRSA ADI program. Molecular analyses included strain typing by pulsed-field gel electrophoresis,\n            <jats:italic>mec<\/jats:italic>\n            and accessory gene regulator group genotyping by multiplex PCR, and identification of toxin and potential virulence factor genes via PCR-based assays. Of 8,387 neonates, 115 (1.4%) had MRSA colonization and\/or infection. The MRSA colonization rate declined significantly during the study period from 2.2 to 0.5\/1,000 patient days (linear time,\n            <jats:italic>P<\/jats:italic>\n            = 0.0003; quadratic time,\n            <jats:italic>P<\/jats:italic>\n            = 0.006). There were 19 cases of MRSA infection (16.5%). Few epidemiologic or clinical differences were identified between MRSA-colonized and MRSA-infected infants. Thirty-one different strains of MRSA were identified with a shift from hospital-associated to combined hospital- and community-associated strains over time. Panton-Valentine leukocidin-positive USA300 strains caused 5 of the last 11 infections. Staphylococcal cassette chromosome\n            <jats:italic>mec<\/jats:italic>\n            (SCC\n            <jats:italic>mec<\/jats:italic>\n            ) types II and IVa and\n            <jats:italic>agr<\/jats:italic>\n            groups 1 and 2 were most predominant. One isolate possessed the gene for toxic shock syndrome toxin; none had genes for exfoliative toxin A or B. These results highlight recent trends in MRSA colonization and infection and the corresponding changes in molecular epidemiology. Continued vigilance for this invasive pathogen remains critical, and specific attention to the unique host, the neonate, and the distinct environment, the NICU, is imperative.\n          <\/jats:p>","DOI":"10.1128\/jcm.00470-15","type":"journal-article","created":{"date-parts":[[2015,5,28]],"date-time":"2015-05-28T12:54:13Z","timestamp":1432817653000},"page":"2492-2501","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":36,"title":["Clinical and Molecular Epidemiology of Methicillin-Resistant Staphylococcus aureus in a Neonatal Intensive Care Unit in the Decade following Implementation of an Active Detection and Isolation Program"],"prefix":"10.1128","volume":"53","author":[{"given":"Melissa U.","family":"Nelson","sequence":"first","affiliation":[{"name":"Division of Perinatal Medicine, Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J.","family":"Bizzarro","sequence":"additional","affiliation":[{"name":"Division of Perinatal Medicine, Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert S.","family":"Baltimore","sequence":"additional","affiliation":[{"name":"Division of Infectious Disease, Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut, USA"},{"name":"Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Connecticut, USA"},{"name":"Department of Hospital Epidemiology, Yale-New Haven Hospital, New Haven, Connecticut, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise M.","family":"Dembry","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Connecticut, USA"},{"name":"Department of Hospital Epidemiology, Yale-New Haven Hospital, New Haven, Connecticut, USA"},{"name":"Division of Infectious Disease, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick G.","family":"Gallagher","sequence":"additional","affiliation":[{"name":"Division of Perinatal Medicine, Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut, USA"},{"name":"Department of Pathology, Yale University School of Medicine, New Haven, Connecticut, USA"},{"name":"Department of Genetics, Yale University School of Medicine, New Haven, Connecticut, 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