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Outbreak Due to Methicillin- and Rifampin- Resistant Staphylococcus aureus: Epidemiology and Eradication of the Resistant Strain from the Hospital

Published online by Cambridge University Press:  02 January 2015

Cynthia M. Bitar ,
C. Glen Mayhall ,
V. Archer Lamb ,
Thomas J. Bradshaw ,
Alice C. Spadora  and
Harry P. Dalton
Cynthia M. Bitar
Affiliation:
Hospital Epidemiology Unit, Division of Infectious Diseases; Department of Medicine; Department of Biostatistics; Department of Pathology, Medical College of Virginiaand theMedical College of Virginia Hospitals, Virginia Commonwealth University, Richmond, Virginia
C. Glen Mayhall*
Affiliation:
Hospital Epidemiology Unit, Division of Infectious Diseases; Department of Medicine; Department of Biostatistics; Department of Pathology, Medical College of Virginiaand theMedical College of Virginia Hospitals, Virginia Commonwealth University, Richmond, Virginia
V. Archer Lamb
Affiliation:
Hospital Epidemiology Unit, Division of Infectious Diseases; Department of Medicine; Department of Biostatistics; Department of Pathology, Medical College of Virginiaand theMedical College of Virginia Hospitals, Virginia Commonwealth University, Richmond, Virginia
Thomas J. Bradshaw
Affiliation:
Hospital Epidemiology Unit, Division of Infectious Diseases; Department of Medicine; Department of Biostatistics; Department of Pathology, Medical College of Virginiaand theMedical College of Virginia Hospitals, Virginia Commonwealth University, Richmond, Virginia
Alice C. Spadora
Affiliation:
Hospital Epidemiology Unit, Division of Infectious Diseases; Department of Medicine; Department of Biostatistics; Department of Pathology, Medical College of Virginiaand theMedical College of Virginia Hospitals, Virginia Commonwealth University, Richmond, Virginia
Harry P. Dalton
Affiliation:
Hospital Epidemiology Unit, Division of Infectious Diseases; Department of Medicine; Department of Biostatistics; Department of Pathology, Medical College of Virginiaand theMedical College of Virginia Hospitals, Virginia Commonwealth University, Richmond, Virginia
*
Hospital Epidemiology Unit, Division of Infectious Diseases, MCV Station, Box 19, Richmond, VA 23298-0001
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Abstract

A methicillin- and rifampin-resistant strain of Staphylococcus aureus was introduced into a university hospital by interstate transfer of an infected surgical patient. An outbreak occurred, and 17 patients became infected or colonized with the epidemic strain. Reservoirs appeared to be patients who were infected or colonized with the resistant S aureus and possibly two nurses who were nasal carriers. The outbreak isolate was likely spread by contact with contaminated hands of personnel. A retrospective case-control study identified tracheostomy, debridement, and irrigation of wounds by power spray and prolonged nasogastric intubation as risk factors for acquisition of the epidemic strain. Analysis of factors by groups indicated that surgical procedures, wound care procedures and instrumentation of the respiratory tract were significantly associated with cases. The nasal carrier state was eradicated in two nurses by topical application of 5% vancomycin. The epidemic strain was eradicated from the hospital 8 months after it was introduced.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 8 , Issue 1 , January 1987 , pp. 15 - 23
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1987

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