Nosocomial transmission of community-acquired methicillin-resistant Staphylococcus aureus in a well-infant nursery of a teaching hospital
Article first published online: 11 SEP 2012
© 2012 The Authors. Pediatrics International © 2012 Japan Pediatric Society
Volume 54, Issue 6, pages 786–792, December 2012
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
- Issue published online: 21 DEC 2012
- Article first published online: 11 SEP 2012
- Accepted manuscript online: 28 MAY 2012 10:20PM EST
- Received 26 January 2012; revised 15 May 2012; accepted 17 May 2012.
- community-acquired methicillin-resistant Staphylococcus aureus;
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.