Recent epidemiology of neonatal sepsis in Japan: did the strategies to control and prevent MRSA transmission lead to a reduction in the incidence of late-onset sepsis?

Figures & data

Table 1 Recent incidence of late-onset neonatal sepsis in preterm infants in Japan, the US, and Canada

	Japan^Citation5,Citation25		US^Citation26	Canada^Citation25
	ELBWI n=378	VLBWI n=9,812	VLBWI n=20,472	VLBWI n=5,341
Years	2006–2008	2006–2008	2002–2008	2006–2008
Late-onset sepsis (%)	5.6	5.0	24.4	16.6

Abbreviations: ELBWI, extremely low birth weight infants; VLBWI, very low birth weight infants.

Table 2 Pathogens of late-onset neonatal sepsis in the study of five Japanese NICUs in 2006–2008

	Numbers (%) n=42
Staphylococcus aureus	11 (26%)
MRSA	8 (19%)
MSSA	3 (7%)
Methicillin-resistant coagulase-negative staphylococci	5 (12%)
Pseudomonas aeruginosa	5 (12%)
Escherichia coli	5 (12%)
Group B Streptococcus	3 (7%)
Group A Streptococcus	3 (7%)
Enterobacter cloacae	2 (5%)
Klebsiella pneumoniae	2 (5%)
Others	6 (14%)

Note: Copyright © 2012. S Karger AG, Basel, Switzerland. Reproduced from Morioka I, Morikawa S, Miwa A, et al. Culture-proven neonatal sepsis in Japanese neonatal care units in 2006–2008. Neonatology. 2012;102(1):75–80.⁵

Abbreviations: NICU, neonatal intensive care units; MRSA, methicillin-resistant S. aureus; MSSA, methicillin-sensitive S. aureus.

Table 3 Changes in prevalence of MRSA-colonized infants and measures to control and prevent health care-associated MRSA transmission in Japanese NICUs

Year	2000 65 NICUs	2011 150 NICUs
Prevalence of MRSA-co Ionized infants
Infants without MRSA colonization in NICU	14%	53%

Note: Reproduced with permission from John Wiley and Sons. Prevalence of MRSA colonization in Japanese neonatal care unit patients in 2011. Morioka I, Takahashi N, Kitajima H; Committee for Infection Prevention and Vaccine Promotion of the Japan Society for Premature and Newborn Medicine. Pediatr Int. 2014;56(2):211–214.¹⁶ Copyright © 2013 Morioka I, Takahashi N, Kitajima H. Pediatrics International © 2013 Japan Pediatric Society.

Abbreviations: MRSA, methicillin-resistant Staphylococcus aureus; NICU, neonatal intensive care unit.

Table 4 Measures to control and prevent health care-associated MRSA transmission

Year	2000 91 NICUs	2011 168 NICUs
Measures
Glove use	41%	90%
Cohorting/isolation for MRSA+ infants	58%	73%
Mupirocin for MRSA+ infants	56%	36%
Povidone iodine for umbilical cord	35%	0%
Disinfectants for hand hygiene
Alcohol	0%	89%
Soap	12%	73%
Povidone iodine	71%	21%

Note: Reproduced with permission from John Wiley and Sons. Prevalence of MRSA colonization in Japanese neonatal care unit patients in 2011. Morioka I, Takahashi N, Kitajima H; Committee for Infection Prevention and Vaccine Promotion of the Japan Society for Premature and Newborn Medicine. Pediatr Int. 2014;56(2):211–214.¹⁶ Copyright © 2013 Morioka I, Takahashi N, Kitajima H. Pediatrics International © 2013 Japan Pediatric Society.

Abbreviations: MRSA, methicillin-resistant Staphylococcus aureus; NICU, neonatal intensive care unit.

Morioka I, Morikawa S, Miwa A, et al. Culture-proven neonatal sepsis in Japanese neonatal care units in 2006–2008. Neonatology. 2012;102(1):75–80.

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Morioka I, Takahashi N, Kitajima H; Committee for Infection Prevention and Vaccine Promotion of the Japan Society for Premature and Newborn Medicine. Prevalence of MRSA colonization in Japanese neonatal care unit patients in 2011. Pediatr Int. 2014;56(2):211–214.

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