Skip to main content Accessibility help
×
Home
Hostname: page-component-79b67bcb76-6tv95 Total loading time: 0.213 Render date: 2021-05-12T21:57:40.006Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": false, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true }

An Outbreak of Methicillin-Resistant Staphylococcus aureus in a Neonatal Intensive Care Unit

Published online by Cambridge University Press:  02 January 2015

Lisa Saiman
Affiliation:
Department of Pediatrics, Columbia Universityand New York Presbyterian Medical Center, Children's Hospital of New York, New York, New York Department of Epidemiology, Columbia Universityand New York Presbyterian Medical Center, Children's Hospital of New York, New York, New York
Alicia Cronquist
Affiliation:
Department of Epidemiology, Columbia Universityand New York Presbyterian Medical Center, Children's Hospital of New York, New York, New York Epidemic Intelligence Service, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia
Fann Wu
Affiliation:
Department of Pathology, Columbia Universityand New York Presbyterian Medical Center, Children's Hospital of New York, New York, New York
Juyan Zhou
Affiliation:
Department of Pediatrics, Columbia Universityand New York Presbyterian Medical Center, Children's Hospital of New York, New York, New York
David Rubenstein
Affiliation:
Department of Pediatrics, Columbia Universityand New York Presbyterian Medical Center, Children's Hospital of New York, New York, New York
William Eisner
Affiliation:
Public Health Research Institute Tuberculosis Center, Newark, New Jersey
Barry N. Kreiswirth
Affiliation:
Public Health Research Institute Tuberculosis Center, Newark, New Jersey
Phyllis Della-Latta
Affiliation:
Department of Pathology, Columbia Universityand New York Presbyterian Medical Center, Children's Hospital of New York, New York, New York

Abstract

Objective:

To describe the epidemiologic and molecular investigations that successfully contained an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) in a neonatal intensive care unit (NICU).

Design:

Isolates of MRSA were typed by pulsed-field gel electrophoresis (PFGE) and S. aureus protein A (spa).

Setting:

A level III-IV, 45-bed NICU located in a children's hospital within a medical center.

Patients:

Incident cases had MRSA isolated from clinical cultures (eg, blood) or surveillance cultures (ie, anterior nares).

Interventions:

Infected and colonized infants were placed on contact precautions, cohorted, and treated with mupirocin. Surveillance cultures were performed for healthcare workers (HCWs). Colonized HCWs were treated with topical mupirocin and hexachlorophene showers.

Results:

From January to March 2001, the outbreak strain of MRSA PFGE clone B, was harbored by 13 infants. Three (1.3%) of 235 HCWs were colonized with MRSA. Two HCWs, who rotated between the adult and the pediatric facility, harbored clone C. One HCW, who exclusively worked in the children's hospital, was colonized with clone B. From January 1999 to November 2000, 22 patients hospitalized in the adult facility were infected or colonized with clone B. Spa typing and PFGE yielded concordant results. PFGE clone B was identified as spa type 16, associated with outbreaks in Brazil and Hungary.

Conclusions:

A possible route of MRSA transmission was elucidated by molecular typing. MRSA appears to have been transferred from our adult facility to our pediatric facility by a rotating HCW. Spa typing allowed comparison of our institution's MRSA strains with previously characterized outbreak clones.

Type
Orginal Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2003

Access options

Get access to the full version of this content by using one of the access options below.

References

1.Lejeune, B, Buzit-Losquin, F, Simitzis-Le Flohic, AM, Le Bras, MP, Alix, D. Outbreak of gentaraicin-methicillin-resistant Staphylococcus aureus infection in an intensive care unit for children. J Hosp Infect 1986;7:2125.CrossRefGoogle Scholar
2.Graham, DR, Correa-Villasenor, A, Anderson, RL, Vollman, JH, Baine, WB. Epidemic neonatal gentamicin-methicillin-resistant Staphylococcus aureus infection associated with nonspecific topical use of gentamicin. J Pediatr 1980;97:972978.CrossRefGoogle ScholarPubMed
3.Campbell, JR, Zaccaria, E, Mason, EO, Baker, CJ. Epidemiological analysis defining concurrent outbreaks of Serratia marcescens and methicillin-resistant Staphylococcus aureus in a neonatal intensive care unit. Infect Control Hosp Epidemiol 1998;19:924928.CrossRefGoogle Scholar
4.Jernigan, JA, Titus, MG, Gröschel, DHM, Getchell-White, SI, Farr, BM. Effectiveness of contact isolation during a hospital outbreak of methicillin-resistant Staphylococcus aureus. Am J Epidemiol 1996;143:496504.CrossRefGoogle Scholar
5.Davies, EA, Emmerson, AM, Hogg, GM, Patterson, MF, Shields, MD. An outbreak of infection with a methicillin-resistant Staphylococcus aureus in a special care baby unit: value of topical mupirocin and traditional methods of infection control. J Hosp Infect 1987;10:120128.CrossRefGoogle Scholar
6.Morel, AS, Wu, F, Della-Latta, P, Cronquist, A, Rubenstein, D, Saiman, L. Nosocomial transmission of methicillin-resistant Staphylococcus aureus from a mother to her preterm quadruplet infants. Am J Infect Control 2002;30:170173.CrossRefGoogle ScholarPubMed
7.Roberts, RB, de Lencastre, A, Eisner, W, et al.Molecular epidemiology of methicillin-resistant Staphylococcus aureus in 12 New York hospitals. J Infect Dis 1998;178:164171.CrossRefGoogle ScholarPubMed
8.Tenover, FC, Arbeit, RD, Goering, RV, et al.Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing. J Clin Microbiol 1995;33:22332239.Google Scholar
9.Shopsin, B, Gomez, M, Montogomery, SO, et al.Evaluation of protein A gene polymorphic region DNA sequencing for typing Staphylococcus aureus strains. J Clin Microbiol 1999;37:35563563.Google ScholarPubMed
10.Doebbeling, BN, Breneman, DL, Neu, HC, et al.Elimination of Staphylococcus aureus nasal carriage in health care workers: analysis of six clinical trials with calcium mupirocin ointment Clin Infect Dis 1993;17:466474.CrossRefGoogle Scholar
11.Oliveira, DC, Crisostomo, I, Santos-Sanches, I, et al.Comparison of DNA sequencing of the protein A gene polymorphic region with other molecular typing techniques for typing two epidemiologically diverse collections of methicillin-resistant Staphylococcus aureus. J Clin Microbiol 2001;39:574580.CrossRefGoogle ScholarPubMed
12.Oliveira, DC, Tomasz, A, de Lencastre, H. The evolution of pandemic clones of methicillin-resistant Staphylococcus aureus: identification of two ancestral genetic backgrounds and the associated mec elements. Microb Drug Resist 2001;7:349361.CrossRefGoogle ScholarPubMed
13.Roberts, RB, Tennenberg, AM, Eisner, W, et al.Outbreak in a New York City teaching hospital burn center caused by the Iberian epidemic clone of MRSA. Microb Drug Resist 1998;4:175183.CrossRefGoogle Scholar
14.Sohn, AH, Garrett, DO, Sinkowitz-Cochran, RL, et al.Prevalence of nosocomial infections in neonatal intensive care unit patients: results from the first national point-prevalence survey. J Pediatr 2001;139:821827.CrossRefGoogle ScholarPubMed
15.Fridkin, SK, Edwards, JR, Tenover, FC, Gaynes, RP, McGowan, JE, for the Intensive Care Antimicrobial Resistance Epidemiology (ICARE) Project and the National Nosocomial Infections Surveillance (NNIS) System Hospitals. Antimicrobial resistance prevalence rates in hospital antibiograms reflect prevalence rates among pathogens associated with hospital-acquired infections. Clin Infect Dis 2001;33:324330.CrossRefGoogle ScholarPubMed

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

An Outbreak of Methicillin-Resistant Staphylococcus aureus in a Neonatal Intensive Care Unit
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

An Outbreak of Methicillin-Resistant Staphylococcus aureus in a Neonatal Intensive Care Unit
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

An Outbreak of Methicillin-Resistant Staphylococcus aureus in a Neonatal Intensive Care Unit
Available formats
×
×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *