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Effectiveness of Simple Measures to Control an Outbreak of Nosocomial Methicillin-Resistant Staphylococcus aureus Infections in an Intensive Care Unit

Published online by Cambridge University Press:  21 June 2016

M. Guiguet*
Affiliation:
INSERM U 263, Paris, France
C. Rekacewicz
Affiliation:
Znstitut Gustave Roussy, Villejuif, France
B. Leclercq
Affiliation:
Znstitut Gustave Roussy, Villejuif, France
Y. Brun
Affiliation:
Laboratoire National de la Santé, Lyon, France
B. Escudier
Affiliation:
Znstitut Gustave Roussy, Villejuif, France
A. Andremont
Affiliation:
Znstitut Gustave Roussy, Villejuif, France
*
URBB, Université Paris 7, 2 place Jussieu, 75005 Paris, France

Abstract

Between June 1985 and March 1986, 14 cases of severe nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infection, including septicemia, were observed in the intensive care unit (ICU) of a 400-bed cancer reference center. Simple control measures including contact isolation of colonized patients and reinforcement of handwashing practices among personnel were followed by a sharp decrease in the rate of infection and colonization. An epidemiological investigation showed that a single serophage variant MRSA strain was involved; peak incidence of infection was 17 per 100 ICU patient discharges; the index case was identified as a patient admitted from another hospital and the epidemic strain was then transmitted from patient-to-patient in the ICU; risk factors for acquiring infection were length of prior hospitalization, invasive procedures and number of antibiotic treatments; dissemination of the strain to other wards was only anecdotal. These results stress the effectiveness of simple measures to control outbreaks of MRSA nosocomial infections even in immunocompromised cancer patients.

Type
Original articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1990

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References

1. Eykyn, SJ. Staphylococcal sepsis: the changing pattern of disease and therapy. Lancet. 1988;1:100104.10.1016/S0140-6736(88)90294-2CrossRefGoogle ScholarPubMed
2. Centers for Disease Control. Nosocomial surveillance 1984. Surveillance Summaries. 1986;35(No. lSS):17SS29SS.Google Scholar
3. Boyce, JM, White, RL, Causey, WA, Lockwood, WR. Burn units as a source of methicillin resistant Staphylococcus aureus infection. JAMA. 1983;249:28032807.10.1001/jama.1983.03330440041029CrossRefGoogle Scholar
4. Linneman, CC Jr, Mason, M, Moore, P, Korfhagen, TR, Staneck, JL. Methicillin resistant Staphylococcus aureus: experience in a general hospital over four years.Am J Epidemiol. 1982;115:941950.10.1093/oxfordjournals.aje.a113381CrossRefGoogle Scholar
5. Gutmann, L, Goldstein, R. Staphylocoques et beta-lactamines. In: Couvalin, P, ed. L'antibiogramme. Paris, France: MPC-Videom;1985; 2328.Google Scholar
6. Fleurette, J Modjadedy, A. Attempts to combine and simplify two methods for serotyping of Staphylococcus aureus. Zentralblatt fur Bakteriologie, Parasitenkunde, Infection-Krankheiten and Hygiene. 1976;Suppl 5:7180.Google Scholar
7. De Saxe, M, Rosendal, K. International committee on systematic bacteriology subcommittee on phage-typing of staphylococci. Minutes of the meeting; 2 Sept 78. Int J Syst Bact. 1982;32:253254.Google Scholar
8. Cuzick, J. A Wilcoxon-type test for trend. Statistics in Medicine. 1985;4:8790.10.1002/sim.4780040112CrossRefGoogle ScholarPubMed
9. Legall, JR, Loirat, PH, Alperovitch, A, et al. A simplified acute physiology score for ICU patients. Crit Care Med. 1984;12:975977.Google Scholar
10. Locksey, RM, Cohen, ML, Quinn, TC, et al. Multiply antibiotic-resistant Staphylococcus aureus: introduction, transmission and evolution of nosocomial infection. Ann Intern Med. 1982;97:317324.10.7326/0003-4819-97-3-317CrossRefGoogle Scholar
11. Rimland, D. Nosocomial infections with methicillin and tobramycin resistant Staphylococcus aureus. Implication of physiotherapy in hospital-wide dissemination. Am J Med Sci. 1985;290:9197.10.1097/00000441-198509000-00002CrossRefGoogle ScholarPubMed
12. Lentino, JR, Hennein, H, Krause, S, et al. A comparison of pneumonia caused by gentamicin, methicillin-resistant and gentamicin, methicillin-sensitive Staphylococcus aureus: epidemiologic and clinical studies. Infect Control. 1985;6:267272.10.1017/S0195941700061737CrossRefGoogle ScholarPubMed
13. Longfield, JN, Townsend, TR, Cruess, DF, et al. Methicillin-resistant Staphylococcus aureus (MRSA): risk and outcome of colonized vs infected patients. Infect Control. 1985;6:445450.10.1017/S0195941700064791CrossRefGoogle ScholarPubMed
14. Kristinsson, KG, Fenton, P. Norman, P. Control ofepidemic methicillin-resistant Staphylococcus aureus. Lancet. 1987;i:274275.10.1016/S0140-6736(87)90093-6CrossRefGoogle Scholar
15. Aldridge, KE. Methicillin-resistant Staphylococcus aureus: clinical and laboratory features. Infect Control. 1985;6:461465.10.1017/S0195941700064833CrossRefGoogle ScholarPubMed
16. Hospital Infection Society, British Society for Antimicrobial Chemotherapy. Guidelines for the control of epidemic methicillin-resistant Staphylococcus aureus. J Hosp Infect. 1986;7:193201.10.1016/0195-6701(86)90064-2CrossRefGoogle Scholar
17. Boyce, JM, White, RL, Spruill, EY. Impact of methicillin resistant Staphylococcus aureus on the incidence of nosocomial staphylococcal infections. J Infect Dis. 1983;148:763.10.1093/infdis/148.4.763CrossRefGoogle ScholarPubMed
18. Thompson, RL, Cabezudo, I, Wenzel, RP. Epidemiology of nosocomial infections caused by methicillin-resistant Staphylococcus aureus. Ann Intern Med. 1982;97:309317.10.7326/0003-4819-97-3-309CrossRefGoogle ScholarPubMed