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An Outbreak of Methicillin-Resistant Staphylococcus aureus in a Neonatal Intensive Care Unit

Published online by Cambridge University Press:  02 January 2015

Lisa Saiman ,
Alicia Cronquist ,
Fann Wu ,
Juyan Zhou ,
David Rubenstein ,
William Eisner ,
Barry N. Kreiswirth  and
Phyllis Della-Latta
Lisa Saiman*
Affiliation:
Department of Pediatrics, Columbia Universityand New York Presbyterian Medical Center, Children's Hospital of New York, New York, New York Department of Epidemiology, Columbia Universityand New York Presbyterian Medical Center, Children's Hospital of New York, New York, New York
Alicia Cronquist
Affiliation:
Department of Epidemiology, Columbia Universityand New York Presbyterian Medical Center, Children's Hospital of New York, New York, New York Epidemic Intelligence Service, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia
Fann Wu
Affiliation:
Department of Pathology, Columbia Universityand New York Presbyterian Medical Center, Children's Hospital of New York, New York, New York
Juyan Zhou
Affiliation:
Department of Pediatrics, Columbia Universityand New York Presbyterian Medical Center, Children's Hospital of New York, New York, New York
David Rubenstein
Affiliation:
Department of Pediatrics, Columbia Universityand New York Presbyterian Medical Center, Children's Hospital of New York, New York, New York
William Eisner
Affiliation:
Public Health Research Institute Tuberculosis Center, Newark, New Jersey
Barry N. Kreiswirth
Affiliation:
Public Health Research Institute Tuberculosis Center, Newark, New Jersey
Phyllis Della-Latta
Affiliation:
Department of Pathology, Columbia Universityand New York Presbyterian Medical Center, Children's Hospital of New York, New York, New York
*
Columbia University, 650 West 168th Street, PH 4W Room 470, New York, NY 10032
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Abstract

Objective:

To describe the epidemiologic and molecular investigations that successfully contained an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) in a neonatal intensive care unit (NICU).

Design:

Isolates of MRSA were typed by pulsed-field gel electrophoresis (PFGE) and S. aureus protein A (spa).

Setting:

A level III-IV, 45-bed NICU located in a children's hospital within a medical center.

Patients:

Incident cases had MRSA isolated from clinical cultures (eg, blood) or surveillance cultures (ie, anterior nares).

Interventions:

Infected and colonized infants were placed on contact precautions, cohorted, and treated with mupirocin. Surveillance cultures were performed for healthcare workers (HCWs). Colonized HCWs were treated with topical mupirocin and hexachlorophene showers.

Results:

From January to March 2001, the outbreak strain of MRSA PFGE clone B, was harbored by 13 infants. Three (1.3%) of 235 HCWs were colonized with MRSA. Two HCWs, who rotated between the adult and the pediatric facility, harbored clone C. One HCW, who exclusively worked in the children's hospital, was colonized with clone B. From January 1999 to November 2000, 22 patients hospitalized in the adult facility were infected or colonized with clone B. Spa typing and PFGE yielded concordant results. PFGE clone B was identified as spa type 16, associated with outbreaks in Brazil and Hungary.

Conclusions:

A possible route of MRSA transmission was elucidated by molecular typing. MRSA appears to have been transferred from our adult facility to our pediatric facility by a rotating HCW. Spa typing allowed comparison of our institution's MRSA strains with previously characterized outbreak clones.

Type
Orginal Articles
Information
Infection Control & Hospital Epidemiology , Volume 24 , Issue 5 , May 2003 , pp. 317 - 321
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2003

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