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What’s New in the Patient Safety World

February 2020

NICU: Decolonize the Parents


Staph aureus has long been a leading cause of nosocomial infections in neonatal intensive care units (NICU’s). Attempts to reduce transmission of Staph aureus from any source would be welcome. Parents of neonates are one of those potential sources. The TREAT PARENTS (Treating Parents to Reduce Neonatal Transmission of Staphylococcus aureus) trial (Milstone 2019) has now demonstrated that treatment of parents colonized with Staph aureus with intranasal mupirocin and chlorhexidine-impregnated cloths compared with placebo significantly reduced neonatal colonization with an Staph aureus strain concordant with a parental baseline strain. This was a double-blinded randomized clinical trial conducted in 2 NICU’s.


Colonization with parental strains of Staph aureus strain occurred in 14.6% of neonates in the intervention group versus 28.7% in the control group.


Minor adverse events that occurred in treated parents were mostly mild skin irritation or nasal congestion and no major adverse events occurred in treated parents.


The study is considered to be preliminary and should seek replication in other settings. Also, because of low numbers of patients, the study was not able to demonstrate that their findings translate to a reduction in symptomatic Staph aureus infections in the neonates. Nor was it powered enough to show that mortality or NICU length of stay (LOS) were impacted by the intervention. The cost effectiveness was not noted but the cost of the intervention was likely low. Those are good questions for larger, multicenter studies. But, certainly, the results of TREAT PARENTS are encouraging and should lead to further investigation.






Milstone AM, Voskertchian A, Koontz DW, et al. Effect of Treating Parents Colonized with Staphylococcus aureus on Transmission to Neonates in the Intensive Care Unit: A Randomized Clinical Trial. JAMA 2019; Published online December 30, 2019





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