Outbreak among healthy newborns due to a new variant of USA300-related meticillin-resistant Staphylococcus aureus

J Hosp Infect. 2014 Jul;87(3):145-51. doi: 10.1016/j.jhin.2014.04.003. Epub 2014 Apr 30.

Abstract

Background: The prevalence of community-associated meticillin-resistant Staphylococcus aureus (CA-MRSA) is increasing throughout the world and is an important cause of skin and soft tissue infection (SSTI) in children and neonates.

Aim: To describe the successful control of an outbreak caused by a new strain of CA-MRSA in a newborn nursery.

Methods: The investigation of the outbreak in July 2012 is reported with the control measures taken. Molecular typing of the MRSA isolates was performed.

Findings: An outbreak of SSTI caused by CA-MRSA occurred in a newborn nursery. Six neonates were infected in a one-month period [infection rate: 8.5% (6/71)]. A new variant of CA-MRSA was responsible, which was characterized as USA300-related, Panton-Valentine Leucocidin (PVL) positive, arginine catabolic mobile element (ACME) negative, sequence type 8 (ST8), staphylococcal cassette chromosome mec (SCCmec) type IVa, agr type I and spa type t008. The outbreak among term neonates followed a rapid transmission pattern and was successfully controlled by implementing various outbreak control measures, including universal chlorhexidine bathing.

Conclusion: This is the first report of a hospital outbreak caused by a USA300-related CA-MRSA clone in Korea. Early recognition and reinforcement of infection control measures are important in decreasing transmission of CA-MRSA in a hospital setting.

Keywords: Community-associated infection; Disease outbreak; Meticillin-resistant Staphylococcus aureus; Newborn; Panton–Valentine leucocidin.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Anti-Infective Agents, Local / therapeutic use
  • Chlorhexidine / therapeutic use
  • Cross Infection / epidemiology*
  • Cross Infection / microbiology
  • Cross Infection / prevention & control
  • DNA, Bacterial / genetics
  • Disease Outbreaks*
  • Disease Transmission, Infectious / prevention & control
  • Humans
  • Infant, Newborn
  • Infection Control / methods
  • Methicillin-Resistant Staphylococcus aureus / classification
  • Methicillin-Resistant Staphylococcus aureus / genetics
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification*
  • Molecular Typing
  • Republic of Korea / epidemiology
  • Staphylococcal Infections / epidemiology*
  • Staphylococcal Infections / microbiology
  • Staphylococcal Infections / prevention & control
  • Virulence Factors / genetics

Substances

  • Anti-Infective Agents, Local
  • DNA, Bacterial
  • Virulence Factors
  • Chlorhexidine