Skip to main content Accessibility help

A Prolonged Outbreak of Methicillin-Resistant Staphylococcus aureus in the Burn Unit of a Tertiary Medical Center

  • Patricia A. Meier (a1), Cheryl D. Carter (a1), Sarah E. Wallace (a1), Richard J. Hollis (a1) (a2), Michael A. Pfaller (a1) (a2) and Loreen A. Herwaldt (a1) (a2) (a3)...



To report an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) in our burn unit and the steps we used to eradicate the organism.

Design And Setting:

Outbreak investigation in the burn unit of a 900-bed tertiary-care medical center.


Between March and June 1993, MRSA was isolated from 10 patients in our burn unit. All isolates had identical antibiograms and chromosomal DNA patterns.

Control Measures:

Infection control personnel encouraged healthcare workers to wash their hands after each patient contact. The unit cohorted all infected or colonized patients, placed each affected patient in isolation, and, if possible, transferred the patient to another unit. Despite these measures, new cases occurred. Infection control personnel obtained nares cultures from 56 healthcare workers, 3 of whom carried the epidemic MRSA strain. One healthcare worker cared for six affected patients, and one cared for five patients. We treated the three healthcare workers with mupirocin. Subsequently, no additional patients became colonized or infected with the epidemic MRSA strain.


The outbreak ended after we treated healthcare workers who carried the epidemic strain with mupirocin. This approach is not appropriate in all settings. However, we felt it was justified in this case because of a persistent problem after less intrusive measures.


Corresponding author

University of Iowa Hospitals and Clinics, C41-R, GH, 200 Hawkins Dr, Iowa City, IA 52242-1009


Hide All
1.Boyce, JM. Methicillin-resistant Staphylococcus aureus in hospitals and long-term care facilities: microbiology, epidemiology, and preventive measures. Infect Control Hosp Epidemiol 1992;13:725737.
2.Thompson, RL, Cabezudo, I, Wenzel RP Epidemiology of nosocomial infections caused by methicillin-resistant Staphylococcus aureus. Ann Intern Med 1982;97:309317.
3.Peacock, JE, Marsik, FC, Wenzel, RP. Methicillin-resistant Staphylococcus aureus: introduction and spread within a hospital. Ann Intern Med 1980;93:526532.
4.Arnow, PM, Allyn, PA, Nichols, EM, Hill, DL, Pezzlo, MA, Bartlett, RH. Control of methicillin-resistant Staphylococcus aureus in a burn unit: role of nurse staffing. J Trauma 1982;22:954959.
5.Boyce, JM. Should we vigorously try to contain and control methicillin-resistant Staphylococcus aureus? Infect Control Hosp Epidemiol 1991;12:4654.
6.Phillips, LG, Heggers, JP, Robson, MC. Burn and trauma units as sources of methicillin-resistant Staphylococcus aureus. J Burn Care Rehabil 1992;13:293297.
7.Boyce, JM. Burn units as a source of methicillin-resistant Staphylococcus aureus infections. JAMA 1983;249:28032807.
8.Snyder, LL, Wiebelahus, P, Boon, SE, Morin, RA, Goering, R. Methicillin-resistant Staphylococcus aureus eradication in a burn center. J Burn Care Rehabil 1993;14:164168.
9.Haley, RW. Methicillin-resistant Staphylococcus aureus: do we just have to live with it? Ann Intern Med 1991;114:162164.
10.Mylotte, JM. Control of methicillin-resistant Staphylococcus aureus: the ambivalence persists. Infect Control Hosp Epidemiol 1994;15:7377.
11.National Committee for Clinical Laboratory Standards. Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically. Villanova, PA: NCCL Standards; 1993. Approved standard. Document M7-A3.
12.Pfaller, MA, Hollis, RJ, Sader, HS. Chromosomal restriction fragment analysis by pulsed-field gel electrophoresis. In: Isenberg, HD, ed. Clinical Microbiology Procedures Handbook. Washington, DC: American Society for Microbiology; 1994(suppl 1):112.
13.Boyce, JM, Jackson, MM, Pugliese, G, et al.Methicillin-resistant Staphylococcus aureus (MRSA): a briefing for acute care hospitals and nursing facilities. Infect Control Hosp Epidemiol 1994;15:105115.
14.Trilla, A, Nettleman, MD, Hollis, RJ, Fredrickson, M, Wenzel, RPPfaller, MA. Restriction endonuclease analysis of plasmid DNA from methicillin-resistant Staphylococcus aureus: clinical application over a three-year period. Infect Control Hosp Epidemiol 1993;14:2935.
15.Reboli, AC, John, JFJ, Platt, CG, Cantey, JR. Methicillin-resistant Staphylococcus aureus at a Veterans' Affairs medical center: importance of carriage of the organism by hospital personnel. Infect Control Hosp Epidemiol 1990;11:291296.

A Prolonged Outbreak of Methicillin-Resistant Staphylococcus aureus in the Burn Unit of a Tertiary Medical Center

  • Patricia A. Meier (a1), Cheryl D. Carter (a1), Sarah E. Wallace (a1), Richard J. Hollis (a1) (a2), Michael A. Pfaller (a1) (a2) and Loreen A. Herwaldt (a1) (a2) (a3)...


Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed