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Control of a cluster of community-associated, methicillin-resistant Staphylococcus aureus in neonatology

Pessoa-Silva, C. L.
Dharan, S.
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Published in Journal of Hospital Infection. 2006, vol. 63, no. 1, p. 93-100
Abstract To control an outbreak of community-associated MRSA (CA-MRSA) in a neonatology unit, an investigation was conducted that involved screening neonates and parents, molecular analysis of MRSA isolates and long-term follow-up of cases. During a two-month period in the summer of 2000, Panton-Valentine leukocidin (PVL)-producing CA-MRSA (strain ST5-MRSA-IV) was detected in five neonates. The mother of the index caseshowed signs of mastitis and wound infection and consequently tested positive for CA-MRSA. A small cluster of endemic, PVL-negative MRSA strains (ST228-MRSA-I) occurred in parallel. Enhanced hygiene measures, barrier precautions, topical decolonization of carriers, and cohorting of new admissions terminated the outbreak. Four months after the outbreak, the mother of another neonate developed furunculosis with the epidemic CA-MRSA strain. One infant had persistent CA-MRSA carriage resulting in skin infection in a sibling four years after the outbreak. In conclusion, an epidemic CA-MRSA strain was introduced by the mother of the index case. This spread among neonates and was subsequently transmitted to another mother and a sibling. This is the first report of a successfully controlled neonatology outbreak of genetically distinct PVL-producing CA-MRSA in Europe.
Keywords AdultAnti-Bacterial Agents/therapeutic useCommunity-Acquired Infections/microbiology/prevention & control/transmissionDisease OutbreaksHumansInfant, NewbornInfection Control/ methodsIntensive Care Units, NeonatalMethicillin ResistanceStaphylococcal Infections/drug therapy/ epidemiology/transmissionStaphylococcus aureus/ drug effects/isolation & purification/pathogenicitySwitzerland/epidemiology
PMID: 16542756
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Research groups Groupe Harbarth Stephan (Staphylocoques dorés résistants à la méthicilline) (866)
Staphylocoques dorés résistants à la méthicilline et hygiène hospitalière (330)
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SAX, Hugo et al. Control of a cluster of community-associated, methicillin-resistant Staphylococcus aureus in neonatology. In: Journal of Hospital Infection, 2006, vol. 63, n° 1, p. 93-100. doi: 10.1016/j.jhin.2005.11.016 https://archive-ouverte.unige.ch/unige:7570

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Deposited on : 2010-06-21

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