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

Published online by Cambridge University Press:  02 January 2015

Patricia A. Meier ,
Cheryl D. Carter ,
Sarah E. Wallace ,
Richard J. Hollis ,
Michael A. Pfaller  and
Loreen A. Herwaldt
Patricia A. Meier
Affiliation:
University of Iowa Hospitals and Clinics, Iowa City, Iowa
Cheryl D. Carter
Affiliation:
University of Iowa Hospitals and Clinics, Iowa City, Iowa
Sarah E. Wallace
Affiliation:
University of Iowa Hospitals and Clinics, Iowa City, Iowa
Richard J. Hollis
Affiliation:
University of Iowa Hospitals and Clinics, Iowa City, Iowa University of Iowa College of Medicine, Iowa City, Iowa
Michael A. Pfaller
Affiliation:
University of Iowa Hospitals and Clinics, Iowa City, Iowa University of Iowa College of Medicine, Iowa City, Iowa
Loreen A. Herwaldt*
Affiliation:
University of Iowa Hospitals and Clinics, Iowa City, Iowa University of Iowa College of Medicine, Iowa City, Iowa Veterans' Administration Medical Center, Iowa City, Iowa
*
University of Iowa Hospitals and Clinics, C41-R, GH, 200 Hawkins Dr, Iowa City, IA 52242-1009
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Abstract

Objective:

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.

Outbreak:

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.

Conclusions:

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.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 17 , Issue 12 , December 1996 , pp. 798 - 802
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1996

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