Appendix: Recommendations for Prevention and Control of Infections in Neonatal Intensive Care Unit Patients: Staphylococcus aureus September 2020 Table of Contents 1. Search Strategies and Results ....................................................................................................................................................................................................................................... 4 1.A. Guideline Search Strategy ................................................................................................................................................................................................................................. 4 1.B. Primary Search Strategies of Databases: Methicillin-sensitive Staphylococcus aureus: August 3, 2019 .......................................................................................................... 4 1.C. Primary Search Strategies of Databases: Methicillin-resistant Staphylococcus aureus August 3, 2019 ........................................................................................................... 5 2. Study Exclusion Criteria................................................................................................................................................................................................................................................. 7 3. Evidence Review ........................................................................................................................................................................................................................................................... 8 3.A. Summary of Evidence: Interventions to Prevent S. aureus Transmission ......................................................................................................................................................... 8 3.B. Summary of Evidence: Potential Risk Factors and Risk Indicators for S. aureus ............................................................................................................................................. 55 4. Risk of Bias ................................................................................................................................................................................................................................................................ 134 5. Evaluation of the Risk of Bias of an Individual Study ................................................................................................................................................................................................ 136 5.A. Checklist for Observational Studies .............................................................................................................................................................................................................. 136 5.B. Checklist for Diagnostic Studies .................................................................................................................................................................................................................... 136 5.C. Checklist for Descriptive Studies ................................................................................................................................................................................................................... 136 5.D. Translating Risk of Bias into GRADE Tables ................................................................................................................................................................................................... 136 6. HICPAC Recommendation Categorization Scheme (2019) ....................................................................................................................................................................................... 137 7. References ................................................................................................................................................................................................................................................................ 139 8. Acronyms and Abbreviations .................................................................................................................................................................................................................................... 142 September 2020 Page 1 of 142 Appendix: Recommendations for Prevention and Control of Infections in Neonatal Intensive Care Unit Patients: Staphylococcus aureus Tables Tables Table 1 Guideline Search of MEDLINE (April 2011).................................................................................................................................................................................................... 4 Table 2 Infection Control Guideline Websites Searched (April 2011)........................................................................................................................................................................ 4 Table 3 Primary Search of MEDLINE .......................................................................................................................................................................................................................... 4 Table 4 Primary Search of EMBASE ............................................................................................................................................................................................................................ 5 Table 5 Primary Search of Cochrane Library .............................................................................................................................................................................................................. 5 Table 6 Primary Search of CINAHL ............................................................................................................................................................................................................................. 5 Table 7 Primary Search of MEDLINE .......................................................................................................................................................................................................................... 5 Table 8 Primary Search of EMBASE ............................................................................................................................................................................................................................ 6 Table 9 Primary Search of Cochrane Library .............................................................................................................................................................................................................. 6 Table 10 Primary Search of CINAHL ............................................................................................................................................................................................................................. 6 Table 11 Strength of Evidence for Implementing Multi-intervention Strategies to Prevent S. aureus Transmission in NICU Patients ...................................................................... 8 Table 12 Strength of Evidence for Implementing Multi-intervention Strategies to Prevent MRSA Transmission in NICU Patients ......................................................................... 10 Table 13 Strength of Evidence for Implementing Multi-intervention Strategies to Prevent MSSA Transmission in NICU Patients ......................................................................... 11 Table 14 Strength of Evidence for Implementing Preemptive Contact Precautions for Outborn Patients to Prevent MRSA Transmission in NICU Patients .................................. 12 Table 15 Strength of Evidence for Implementing a New Hand Hygiene Policy to Prevent MRSA Transmission in NICU Patients ............................................................................ 12 Table 16 Strength of Evidence for Implementing Active Surveillance Testing to Guide Implementation of any Strategy to Prevent S. aureus Transmission in NICU Patients ..... 12 Table 17 Strength of Evidence for Implementing Active Surveillance Testing to Guide Implementation of any Strategy to Prevent MRSA Transmission in NICU Patients .......... 13 Table 18 Strength of Evidence for Implementing Active Surveillance Testing to Guide Implementation of any Strategy to Prevent MSSA Transmission in NICU Patients .......... 14 Table 19 Strength of Evidence for Implementing Active Surveillance Testing All Infants on Admission to Guide Implementation of any Strategy to Prevent S. aureus Transmission in NICU Patients .................................................................................................................................................................................................................... 14 Table 20 Strength of Evidence for Implementing Active Surveillance Testing All Infants on Admission and Every Two Weeks Thereafter to Guide Implementation of any Strategy to Prevent S. aureus Transmission in NICU Patients ..................................................................................................................................................................... 15 Table 21 Strength of Evidence for Implementing Active Surveillance Testing of All Infants on Admission and Weekly Thereafter to Guide Implementation of any