Hostname: page-component-7c8c6479df-xxrs7 Total loading time: 0 Render date: 2024-03-28T10:28:56.971Z Has data issue: false hasContentIssue false

Outbreak of Staphylococcal Infection in Two Hospital Nurseries Traced to a Single Nasal Carrier

Published online by Cambridge University Press:  02 January 2015

Anusha Belani
Affiliation:
Department of Medicine, Division of Infectious Disease; Department of Pediatrics, Division of Infectious Disease, University of Florida School of Medicine; and the Department of Infection Control, Shands Hospital, Gainesville, Florida
Robert J. Sherertz*
Affiliation:
Department of Medicine, Division of Infectious Disease; Department of Pediatrics, Division of Infectious Disease, University of Florida School of Medicine; and the Department of Infection Control, Shands Hospital, Gainesville, Florida
Marsha L. Sullivan
Affiliation:
Department of Medicine, Division of Infectious Disease; Department of Pediatrics, Division of Infectious Disease, University of Florida School of Medicine; and the Department of Infection Control, Shands Hospital, Gainesville, Florida
Beverly A. Russell
Affiliation:
Department of Medicine, Division of Infectious Disease; Department of Pediatrics, Division of Infectious Disease, University of Florida School of Medicine; and the Department of Infection Control, Shands Hospital, Gainesville, Florida
Peter D. Reumen
Affiliation:
Department of Medicine, Division of Infectious Disease; Department of Pediatrics, Division of Infectious Disease, University of Florida School of Medicine; and the Department of Infection Control, Shands Hospital, Gainesville, Florida
*
Division of Infectious Disease, Box J-277 JHMHC, University of Florida, Gainesville, FL 32610

Abstract

In late January and early February 1983, an outbreak of skin infections (7 of 145 infants) caused by a penicillin/erythromycin resistant strain of Staphylococcus aureus (SA), phage type 3A/3C, occurred in our newborn nursery. A week following the first cluster of infections, another nursery outbreak due to SA with the same antibiogram occurred in a nearby community hospital (11 of 114 infants). Subsequently, a second cluster of infections with the same SA was identified at our nursery. The epidemic strain was carried in the anterior nares of a single nurse who worked at both hospital nurseries on alternate weeks. Investigation revealed that the nurse had an upper respiratory tract infection during each of these outbreaks—simulating “a cloud baby.” No further infections have occurred since this nurse was treated and her SA nasal carrier state eliminated.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1986

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Parker, MT, Kennedy, J: The source of infection in Pemphigus Neonatorum. J Hyg 1949; 47:213219.CrossRefGoogle ScholarPubMed
2.Shaffer, TE, Baldwin, JN, Rheins, MS, et al: Staphylococcal infections in newborn infants: I. Study of an epidemic among infants and nursing mothers. Pediatrics 1956; 18:750761.Google Scholar
3.Shaffer, TE, Sylvester, RF Jr, Baldwin, JN, et al: Staphylococcal infections in newborn infants: II Report of 19 epidemics caused by an identical strain of Staphylococcus pyogenes. Am J Public Health 1957; 47:990995.CrossRefGoogle Scholar
4.Albert, S, Baldwin, R, Czekajewski, S, et al: Bullous impetigo due to group II S. aureus. Am J Dis Child 1970; 12:1013.CrossRefGoogle Scholar
5.Light, IJ, Brackvogel, V, Walton, RL, et al: An epidemic of bullous impetigo arising from a central admission-observation nursery. Pediatrics 1972; 49:1521.Google Scholar
6.Anthony, BF, Giuliano, DM, Oh, W: Nursery outbreak of staphylococcal scalded skin syndrome. Am J Dis Child 1972; 124:4144.CrossRefGoogle ScholarPubMed
7.Florman, AL, Holzman, RS: Nosocomial scalded skin syndrome. Am J Dis Child 1980; 134:10431045.CrossRefGoogle ScholarPubMed
8.Wolinsky, E, Lipsitz, PJ, Mortimer, EA, et al: Acquisition of staphylococci by newborns: Direct versus indirect transmission. Lancet 1960; 2:620622.Google Scholar
9.Mortimer, E, Lipsitz, PJ, Wolinsky, E, et al: Transmission of staphylococci between newborns. Am J Dis Child 1962; 104:289296.CrossRefGoogle ScholarPubMed
10.Haley, RW, Bregman, DA: The role of understaffing and overcrowding in recurrent outbreaks of staphylococcal infection in a neonatal special care unit. J Infect Dis 1982; 145:875885.Google Scholar
11.Fekety, RF, Buchbinder, L, Shaffer, EL, et al: Control of an outbreak of staphylococcal infections among mothers and infants in a suburban hospital. Am J Public Health 1958; 48:298310.Google Scholar
12.Hare, R, Thomas, CGA: The transmission of Staphylococcus aureus. Br Med J 1956; 2:840844.Google Scholar
13.Rafai, B, Juler, GL: An epidemiologic study of postoperative staphylococcal wound infections in patients having vascular procedures. Am Surg 1978; 44:346351.Google Scholar
14.Calia, FM, Wolinsky, E, Mortimer, EA Jr, et al: Importance of the carrier state as a source of Staphylococcus aureus in wound sepsis. J Hyg 1969; 67:4957.Google Scholar
15.Nakashima, AK, Allen, JR, Martone, WJ, et al: Epidemic bullous impetigo in a nursery due to a nasal carrier of Staphylococcus aureus: Role of epidemiology and control measures. Infect Control 1984; 5:326331.Google Scholar
16.Tanner, EI, Bullin, J, Bullin, CH, et al: An outbreak of postoperative sepsis due to a staphylococcal disperser. J Hyg 1980; 85:219225.Google Scholar
17.Bryan, CS, Wilson, RS, Meade, P, et al: Topical antibiotic ointments for staphylococcal nasal carriers: Survey of current practices and comparison of bacitracin and vancomycin ointments. Infect Control 1980; 1:153156.Google Scholar
18.McAnally, TP, Lewis, MR, Brown, DR: Effect of rifampin and bacitracin on nasal carriers of Staphylococcus aureus. Antimicrob Agents Chemother 1984; 25:422426.CrossRefGoogle ScholarPubMed
19.White, A: Relation between quantitative nasal cultures and dissemination of Staphylococci. J Lab Clin Med 1961; 58:273277.Google Scholar
20.Bethune, DW, Blowers, R, Parker, M, et al: Dispersal of Staphylococrus aureus by patients and surgical staff. Lancet 1965; 1:480483.CrossRefGoogle ScholarPubMed
21.Eichenwald, H, Kotsevalov, O, Fasso, LA: The “Cloud baby”: An example of bacterial-viral interaction. Am J Dis Child 1960; 100:161173.Google Scholar