ORIGINAL ARTICLE

Nosocomial transmission of community-acquired methicillin-resistant Staphylococcus aureus in a well-infant nursery of a teaching hospital

  1. Sarah Alsubaie1,2,*,
  2. Khawater Bahkali2,
  3. Ali M. Somily3,
  4. Fahad Alzamil1,
  5. Abdulkareem Alrabiaah1,
  6. Abdulkareem Alaska1,4,
  7. Fatmah Alkhattaf2,
  8. Abdelmageed Kambal3,
  9. Ahmed A. Al-Qahtani5,7,
  10. Mohammed N. Al-Ahdal5,6

Article first published online: 11 SEP 2012

DOI: 10.1111/j.1442-200X.2012.03673.x

Issue

Pediatrics International

Pediatrics International

Volume 54, Issue 6, pages 786–792, December 2012

Additional Information

How to Cite

Alsubaie, S., Bahkali, K., Somily, A. M., Alzamil, F., Alrabiaah, A., Alaska, A., Alkhattaf, F., Kambal, A., Al-Qahtani, A. A. and Al-Ahdal, M. N. (2012), Nosocomial transmission of community-acquired methicillin-resistant Staphylococcus aureus in a well-infant nursery of a teaching hospital. Pediatrics International, 54: 786–792. doi: 10.1111/j.1442-200X.2012.03673.x

Author Information

  1. 1

    Departments of Pediatrics

  2. 2

    Infection Prevention and Control

  3. 3

    Pathology, Microbiology Unit

  4. 4

    Medicine, College of Medicine, King Saud University and King Khalid University Hospital

  5. 5

    Department of Infection and Immunity, Research Center

  6. 6

    Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Centre

  7. 7

    Liver Disease Research Center, King Saud University, Riyadh, Saudi Arabia

*Sarah Alsubaie, MD, Department of Pediatrics (39), College of Medicine, King Saud University, King Khalid University Hospital, PO Box 2925, Riyadh 11461, Saudi Arabia. Email: salsubaie@ksu.edu.sa

Publication History

  1. Issue published online: 21 DEC 2012
  2. Article first published online: 11 SEP 2012
  3. Accepted manuscript online: 28 MAY 2012 10:20PM EST
  4. Received 26 January 2012; revised 15 May 2012; accepted 17 May 2012.

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Keywords:

  • community-acquired methicillin-resistant Staphylococcus aureus;
  • outbreak;
  • neonate

Abstract

Background:  Infection due to community-acquired strains of methicillin-resistant Staphylococcus aureus (CA-MRSA) has been reported with increasing frequency. Herein is described the nosocomial transmission of CA-MRSA involving 13 neonates and two mothers in a well-infant nursery in a teaching hospital in Saudi Arabia.

Methods:  From October to November 2009, temporally related cases of CA-MRSA skin and soft-tissue infection occurred in newborns shortly after discharge from a well-infant nursery. An outbreak investigation including case identification, review of medical records, staff screening, environmental cultures, pulsed-field gel electrophoresis, and a case–control study were conducted. Controls were selected from among asymptomatic neonates admitted to the same nursery and matched for the day of admission.

Results:  Fifteen subjects were found to be CA-MRSA positive: 13 neonates and two mothers. The crude attack rate among neonates was 5.5% during the outbreak period. All 13 neonates presented with skin and soft-tissue infection; one of the mothers had mastitis and a breast abscess. The source of the outbreak was not evident. Pulsed-field gel electrophoresis showed that all of the tested isolates from one strain except one, all contained the staphylococcal cassette chromosome mec (SCCmec) type IV.

Conclusion:  MRSA strains that initially emerged in the community are now causing disease in health-care settings. Adherence to standard infection control practices, including consistent hand hygiene, in newborn nurseries is important to prevent transmission in such settings.

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