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Antibiotic Prevents Staph Colonies in Newborns

Baby in NICU

(EcoBear, Flickr)

28 Dec. 2018. Results from a clinical trial show a common antibiotic ointment can prevent dangerous staph bacteria from colonizing in vulnerable newborn infants. Findings from the trial among infants and toddlers in neonatal intensive care units appear in the 26 December 2018 issue of the journal Pediatrics (paid subscription required).

The trial, funded by National Institute of Allergy and Infectious Diseases at National Institutes of Health, aimed to determine the utility and safety of applying the antibiotic mupirocin in an ointment to vulnerable newborn infants, such as preterm babies, to prevent Staphylococcus aureus, or S. aureus, bacteria from forming colonies in their bodies. S. aureus bacteria, say the authors, are the second leading cause of dangerous sepsis infections in neonatal intensive care units, so effective strategies are needed to keep the bacteria from finding a home in newborns.

The mid-stage clinical trial, led by University of Maryland pediatrics professor Karen Kotloff, tested mupirocin, a common antibiotic offered as an ointment to treat skin infections, such as impetigo. The study screened some 6,000 children at 8 neonatal ICU, or NICU, sites in the U.S. from newborns to those 24 months old with nasal swabs for the presence of S. aureus bacteria, and enrolled 155 children for the study. Participants were randomly assigned to receive a 5-day course of mupirocin or no treatments for comparison.

“Staph aureus is a leading cause of sepsis in young children admitted to the NICU,” says Kotloff in a university statement. “Sepsis, which is systemic infection, can be fatal in infants. Thus, preventing these infections is very important in managing risk for babies in the NICU who are fragile and struggling with multiple medical problems.”

The results show from 10 to 45 percent of the children screened at the 8 sites, or 18 percent of the total, were found with S. aureus in their bodies. Participants in the mupirocin group received ointment in the nose, umbilical, and anal regions. The study team found S. aureus colonies disappeared in 94 percent of the children receiving mupirocin, compared to 5 percent of children in the comparison group.

The bacteria however reappeared in many of the children. After 2 to 3 weeks, 46 percent of the mupirocin-treated children remained bacteria-free, compared to 2 percent of those who were not treated. The researchers say the mupirocin treatments were generally well-tolerated, with rashes as the most common adverse reactions, particularly in anal regions, rated as mild.

The research team says this is the first randomized clinical trial to test mupirocin treatments in neonatal ICUs. While the results show the treatments are generally safe and initially effective, the persistence of treatments is uneven. Kotloff tells more about the study in the following video.

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