Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-12-01T01:26:58.009Z Has data issue: false hasContentIssue false
  • English
  • Français

Controlling a Multicenter Outbreak Involving the New York/Japan Methicillin-Resistant Staphylococcus aureus Clone

Published online by Cambridge University Press:  02 January 2015

G. W. Coombs ,
H. Van Gessel ,
J. C. Pearson ,
M.-R. Godsell ,
F. G. O'Brien  and
K. J. Christiansen
G. W. Coombs*
Affiliation:
Department of Microbiology and Infectious Diseases, Path West Laboratory Medicine, Western Australia—Royal Perth Hospital, Western Australia, Australia School of Biomedical Sciences, Curtin University of Technology, Western Australia, Australia Gram-Positive Bacteria Typing and Research Unit, Western Australia, Australia
H. Van Gessel
Affiliation:
Department of Microbiology and Infectious Diseases, Path West Laboratory Medicine, Western Australia—Royal Perth Hospital, Western Australia, Australia Clinical Services, Royal Perth Hospital, Perth, Western Australia, Australia
J. C. Pearson
Affiliation:
Department of Microbiology and Infectious Diseases, Path West Laboratory Medicine, Western Australia—Royal Perth Hospital, Western Australia, Australia Gram-Positive Bacteria Typing and Research Unit, Western Australia, Australia
M.-R. Godsell
Affiliation:
Clinical Services, South West Area Health Service, Bunbury, Western Australia, Australia
F. G. O'Brien
Affiliation:
School of Biomedical Sciences, Curtin University of Technology, Western Australia, Australia Gram-Positive Bacteria Typing and Research Unit, Western Australia, Australia
K. J. Christiansen
Affiliation:
Department of Microbiology and Infectious Diseases, Path West Laboratory Medicine, Western Australia—Royal Perth Hospital, Western Australia, Australia School of Biomedical Sciences, Curtin University of Technology, Western Australia, Australia Gram-Positive Bacteria Typing and Research Unit, Western Australia, Australia
*
Department of Microbiology and Infectious Diseases, Royal Perth Hospital, Box X2213 GPO, Perth, Western Australia 6847 ([email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective.

To describe the control of an outbreak of infection and colonization with the New York/Japan methicillin-resistant Staphylococcus aureus (MRSA) clone in multiple healthcare facilities, and to demonstrate the importance of making an MRSA management policy involving molecular typing of MRSA into a statewide public health responsibility.

Setting.

A range of healthcare facilities, including 2 metropolitan teaching hospitals and a regional hospital, as well as several community hospitals and long-term care facilities in a nonmetropolitan healthcare region.

Interventions.

A comprehensive, statewide MRSA epidemiological investigation and management policy.

Results.

In May 2005, there were 3 isolates referred to the Western Australian Gram-Positive Bacteria Typing and Research Unit that were identified as the New York/Japan MRSA clone, a pandemic MRSA clone with the ability to spread and replace existing clones in a region. Subsequent investigation identified 28 additional cases of infection and/or colonization dating from 2002 onward, including 1 involving a colonized healthcare worker (HCW) who had previously been hospitalized overseas. Of the 31 isolates detected, 25 were linked epidemiologically and via molecular typing to the isolate recovered from the colonized HCW. Four isolates appeared to have been introduced separately from overseas. Although the isolate from the single remaining case patient was genetically indistinct from the isolates that spread within Western Australia, no specific epidemiological link could be established. The application of standard outbreak management strategies reduced further spread.

Conclusions.

The elimination of the New/York Japan MRSA clone in a healthcare region demonstrates the importance of incorporating MRSA management policy into statewide public health programs. The mainstays of such programs should include a comprehensive and effective outbreak identification and management policy (including pre-employment screening of HCWs, where applicable) and MRSA clone identification by multilocus sequence typing.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 28 , Issue 7 , July 2007 , pp. 845 - 852
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2007

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.de Lancastre, H, Severina, EP, Roberts, RB, Kreiswirth, BN, Tomasz, A. Testing the efficacy of a molecular surveillance network: methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus faecium (VREF) genotypes in six hospitals in the metropolitan New York city area. The BARG Initiative Pilot Study Group. Bacterial Antibiotic Resistance Group. Microb Drug Resist 1996;2:343–351.Google Scholar
2.Roberts, RB, de Lancastre, A, Eisner, W, et al.Molecular epidemiology of methicillin-resistant Staphylococcus aureus in 12 New York Hospitals. J Infect Dis 1998;178:164–171.Google Scholar
3.Roberts, RB, Chung, M, de Lancastre, H, et al.Distribution of methicillin-resistant Staphylococcus aureus clones among health care facilities in Connecticut, New Jersey and Pennsylvania. Microb Drug Resist 2000;6:245–251.CrossRefGoogle ScholarPubMed
4.Aires de Sousa, A, De Lencastre, H, Santos Sanches, I, Kikuchi, K, Totsuka, T, Tomasz, A. Similarity of antibiotic resistance patterns and molecular typing properties of methicillin-resistant Staphylococcus aureus isolates widely spread in New York City and in a hospital in Tokyo, Japan. Microb Drug Resist 2000;6:253–258.CrossRefGoogle Scholar
5.Hiramatsu, K. Molecular evolution of MRSA. Microbiol Immunol 1995;39:531–543.Google Scholar
6.Tanaka, T, Okuzumi, K, Iwamoto, A, Hiramatsu, K. A retrospective study of methicillin-resistant Staphylococcus aureus clinical strains in Tokyo University Hospital. J Infect Chemother 1995;1:40–49.Google Scholar
7.da Silva Coimbra, MV, Silva-Carvalho, MC, Wisplinghoff, H, et al.Clonal spread of methicillin-resistant Staphylococcus aureus in a large geographic area of the United States. J Hosp Infect 2003;53:103–110.Google Scholar
8.Chung, M, Dickinson, G, de Lencastre, H, Tomasz, A. International clones of methicillin-resistant Staphylococcus aureus in two hospitals in Miami, Florida. J Clin Microbiol 2004;42:542–547.Google Scholar
9.O'Brien, FG, Lim, TT, Winnett, DC, et al.Survey of methicillin-resistant Staphylococcus aureus strains from two hospitals in El Paso, Texas. J Clin Microbiol 2005;43:2969–2972.Google Scholar
10.Simor, AE, Omer-Agostini, M, Bryce, E, et al.Laboratory characterization of methicillin-resistant Staphylococcus aureus in Canadian hospitals: results of 5 years of national surveillance, 1995- 1999. J Infect Dis 2002;186:652–260.Google Scholar
11.Melo, MCN, Silva-Carvalho, MC, Ferrerira, RL, et al.Detection and molecular characterization of a gentamicin-susceptible, methicillin-resistant Staphylococcus aureus (MRSA) clone in Rio de Janeoro that resembles the New York/Japanese clone. J Hosp Infect 2004;58:276–285.CrossRefGoogle Scholar
12.Velazquez-Meza, ME, Aires de Sousa, M, Echaniz-Aviles, G, et al.Surveillance of methicillin-resistant Staphylococcus aureus in a pediatric hospital in Mexico City during a 7-year period (1997-2003): clonal evolution and impact of infection control. J Clin Microbiol 2004;42:3877–3880.Google Scholar
13.Ip, M, Yung, RWH, Ng, TK, et al.Contemporary methicillin-resistant Staphylococcus aureus clones in Hong Kong. J Clin Microbiol 2005;43:5069–5073.Google Scholar
14.Cha, HY, Moon, DC, Choi, CH, et al.Prevalence of the ST239 clone of methicillin-resistant Staphylococcus aureus and differences in antimicrobial susceptibilities of ST239 and ST5 clones identified in a Korean Hospital. J Clin Microbiol 2005;43:3610–3614.Google Scholar
15.Soo Ko, K, Kim, Y-S, Song, J-H, et al.Genotypie diversity of methicillin-resistant Staphylococcus aureus isolated in Korean hospitals. Antimicrob Agents Chemother 2005;49:3583–3585.Google Scholar
16.Conceição, T, Aires, M, deSousa, M, et al. Massive spread of the New York/Japan MRSA clone (ST5-SCCmec II) in a European country. In: Program and abstracts of the 16th European Congress of Clinical Microbiology and Infectious Diseases, European Society of Clinical Microbiology and Infectious Diseases (Nice, France). 2006. Abstract o311. Available at: http://www.blackwellpublishing.com/eccmidl6/abstract.asp?id = 49162. Accessed July 2006.Google Scholar
17.McDougal, LK, Steward, CD, Killgore, GE, Chaitram, JM, McAllister, SK, Tenover, FC. Pulsed-field gel electrophoresis typing of oxacillin-resistant Staphylococcus aureus isolates from the United States: establishing a national database. J Clin Microbiol 2003;41:5113–5120.CrossRefGoogle ScholarPubMed
18.Nimmo, GR, Bell, JM, Mitchell, D, et al.Antimicrobial resistance in Staphylococcus aureus in Australian teaching hospitals 1989-1999. Microb Drug Resist 2003;9:155–160.Google Scholar
19.Coombs, GW, Pearson, JC, O'Brien, FG, Murray, RJ, Grubb, WB, Christiansen, KJ. Methicillin-resistant Staphylococcus aureus clones, Western Australia. Emerg Infect Dis 2006;12:241–247.CrossRefGoogle ScholarPubMed
20.Wenzel, RP, Reagan, DR, Bertino, JS Jr, Baron, EJ, Arias, K. Methicillin-resistant Staphylococcus aureus outbreak: a consensus panel's definition and management guidelines. Am J Infect Control 1998;26:102–110.Google Scholar
21.National Committee for Clinical Laboratory Standards (NCCLS). Performance Standards for Antimicrobial Disk Susceptibility Tests; Approved Standard. 8th ed. Wayne, PA: NCCLS; 2003:M2–A8.Google Scholar
22.Comité de l'Antibiogramme de la Société Française de Microbiologie. Report of the Comité de l'Antibiogramme de la Société Française de Microbiologie: technicla recommendations for in vitro susceptibility testing. Clin Microbiol and Infect 1996;2(suppl 1):S48.Google Scholar
23.Finlay, JE, Miller, LA, Poupards, JA. Interpretive criteria for testing susceptibility of staphylococci to mupirocin. Antimicrob Agents Chemother 1997;41:1137–1139.Google Scholar
24.Clinical and Laboratory Standards Institute (CLSI). Performance Standards for Antimicrobial Susceptibility Testing; 15th Informational Supplement. Wayne, PA: CLSI; 2005:M100–S15.Google Scholar
25.Goh, S-H, Bryne, SK, Zhang, JL, Chow, AW. Molecular typing of Staphylococcus aureus on the basis of coagulase gene polymorphisms. J Clin Microbiol 1992;30:1642–1645.Google Scholar
26.O'Brien, FG, Pearman, JW, Gracey, M, Riley, TV, Grubb, WB. Community strains of methicillin-resistant Staphylococcus aureus involved in a hospital outbreak. J Clin Microbiol 1999;37:2858–2862.Google Scholar
27.Enright, MC, Day, NP, Davies, CE, Peacock, SI, Spratt, BG. Multilocus sequence typing for characterization of methicillin-resistant and meth-icillin-susceptible clones of Staphylococcus aureus. J Clin Microbiol 2000;38:1008–1015.Google Scholar
28.Okuma, K, Iwakawa, K, Turnidge, JD, et al.Dissemination of new methicillin-resistant Staphylococcus aureus clones in the community. J Clin Microbiol 2002;40:4289–4294.Google Scholar
29.Ito, T, Ma, XX, Takeuchi, F, Okuma, K, Yuzawas, H, Hiramatsu, K. Identification of a novel staphylococcal cassette chromosome mec (type V) driven by a novel cassette chromosome ccrC. Antimicrob Agents Chemother 2004;48:2637–2651.Google Scholar
30.Report of a combined working party of the Hospital Infection Society and British Society for Antimicrobial Chemotherapy. J Hosp Infect 1986;7:193–201.Google Scholar
31.Nimmo, GR, Coombs, GW, Pearson, JC, et al.Methicillin-resistant Staphylococcus aureus in the Australian community: an evolving epidemic. MIA 2006;184:384–388.Google Scholar
32.Farr, BM. Doing the right thing (and figuring out what that is). Infect Control Hosp Epidemiol 2006;27:999–1003.Google Scholar
33.Farr, BM. What to think if the results of the National Institutes of Health randomized trial of methicillin-resistant Staphylococcus aureus and van-comycin-resistant Enterococcus control measures are negative (and other advice to young epidemiologists): a review and an au revoir. Infect Control Hosp Epidemiol 2006;27:1096–1106.Google Scholar
34.Kotilainen, P, Routamaa, M, Peltonen, R, et al.Elimination of epidemic methicillin-resistant Staphylococcus aureus from a university hospital and district institutions, Finland. Emerg Infect Dis 2003;9:169–175.Google Scholar
35.Taneike, I, Otsuka, T, Dohmae, S, et al.Molecular nature of methicillin-resistant Staphylococcus aureus derived from explosive nosocomial outbreaks of the 1980s in Japan. FEBS Lett 2006;580:2323–2334.Google Scholar
36.Huang, Y-C, Su, L-H, Wu, T-L, Lin, T-Y. Changing molecular epidemiology of methicillin-resistant Staphylococcus aureus bloodstream isolates from a teaching hospital in northern Taiwan. J Clin Microbiol 2006;44:2268–2270.Google Scholar
37.Pearman, JW, Coombs, GW, Grubb, WB, O'Brien, F. A British epidemic strain of methicillin-resistant Staphylococcus aureus (UK EMRSA-15) in Western Australia. Med J Aust 2001;174:662.Google Scholar
38.Wang, J-T, Chang, S-C, Ko, W-J, et al.A hospital-acquired outbreak of methicillin-resistant Staphylococcus aureus infection initiated by a surgeon carrier. J Hosp Infect 2001;47:104–109.Google Scholar
39.Bertin, ML, Vinski, J, Schmitt, S, et al.Outbreak of methicillin-resistant Staphylococcus aureus colonization and infection in a neonatal intensive care unit epidemiologically linked to a healthcare worker with chronic otitis. Infect Control Hosp Epidemiol 2006;27:581–585.CrossRefGoogle Scholar
40.Blok, HE, Troelstra, A, Titia, EM, et al.Role of healthcare workers in outbreaks of methicillin-resistant Staphylococcus aureus: a 10-year evaluation from a Dutch university hospital. Infect Control Hosp Epidemiol 2003;24:679–685.Google Scholar