TY - JOUR
T1 - The use of typing methods and infection prevention measures to control a bullous impetigo outbreak on a neonatal ward
AU - Koningstein, Maike
AU - Groen, Leon
AU - Geraats-Peters, Kathelijn
AU - Lutgens, Suzanne
AU - Rietveld, Ariene
AU - Jira, Petr
AU - Kluytmans, Jan
AU - de Greeff, Sabine C.
AU - Hermans, Mirjam
AU - Schneeberger, Peter M.
PY - 2012/11/20
Y1 - 2012/11/20
N2 - Background: We describe an outbreak of Bullous Impetigo (BI), caused by a (methicillin susceptible, fusidic acid resistant) Staphylococcus aureus (SA) strain, spa-type t408, at the neonatal and gynaecology ward of the Jeroen Bosch hospital in the Netherlands, from March-November 2011.Methods: We performed an outbreak investigation with revision of the hygienic protocols, MSSA colonization surveillance and environmental sampling for MSSA including detailed typing of SA isolates. Spa typing was performed to discriminate between the SA isolates. In addition, Raman-typing was performed on all t408 isolates.Results: Nineteen cases of BI were confirmed by SA positive cultures. A cluster of nine neonates and three health care workers (HCW) with SA t408 was detected. These strains were MecA-, PVL-, Exfoliative Toxin (ET)A-, ETB+, ETAD-, fusidic acid-resistant and methicillin susceptible. Eight out of nine neonates and two out of three HCW t408 strains yielded a similar Raman type. Positive t408 HCW were treated and infection control procedures were reinforced. These measures stopped the outbreak.Conclusions: We conclude that treatment of patients and HCW carrying a predominant SA t408, and re-implementing and emphasising hygienic measures were effective to control the outbreak of SA t408 among neonates.
AB - Background: We describe an outbreak of Bullous Impetigo (BI), caused by a (methicillin susceptible, fusidic acid resistant) Staphylococcus aureus (SA) strain, spa-type t408, at the neonatal and gynaecology ward of the Jeroen Bosch hospital in the Netherlands, from March-November 2011.Methods: We performed an outbreak investigation with revision of the hygienic protocols, MSSA colonization surveillance and environmental sampling for MSSA including detailed typing of SA isolates. Spa typing was performed to discriminate between the SA isolates. In addition, Raman-typing was performed on all t408 isolates.Results: Nineteen cases of BI were confirmed by SA positive cultures. A cluster of nine neonates and three health care workers (HCW) with SA t408 was detected. These strains were MecA-, PVL-, Exfoliative Toxin (ET)A-, ETB+, ETAD-, fusidic acid-resistant and methicillin susceptible. Eight out of nine neonates and two out of three HCW t408 strains yielded a similar Raman type. Positive t408 HCW were treated and infection control procedures were reinforced. These measures stopped the outbreak.Conclusions: We conclude that treatment of patients and HCW carrying a predominant SA t408, and re-implementing and emphasising hygienic measures were effective to control the outbreak of SA t408 among neonates.
KW - Bullous impetigo
KW - EEFIC
KW - MSSA
KW - Neonate
KW - Raman
UR - https://www.scopus.com/pages/publications/84938483732
U2 - 10.1186/2047-2994-1-37
DO - 10.1186/2047-2994-1-37
M3 - Article
AN - SCOPUS:84938483732
SN - 2047-2994
VL - 1
JO - Antimicrobial Resistance and Infection Control
JF - Antimicrobial Resistance and Infection Control
M1 - 37
ER -