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Investigation of an Outbreak of Methicillin-Resistant Staphylococcus aureus in Patients With Skin Disease Using DNA Restriction Patterns

Published online by Cambridge University Press:  21 June 2016

Richard A. Venezia ,
Valerie Harris ,
Cynthia Miller ,
Hilary Peck  and
Mara San Antonio
Richard A. Venezia*
Affiliation:
Department of Epidemiology, Department of Clinical Microbiology and AIDS Treatment Center, Albany Medical Center, Albany, New York
Valerie Harris
Affiliation:
Department of Epidemiology, Department of Clinical Microbiology and AIDS Treatment Center, Albany Medical Center, Albany, New York
Cynthia Miller
Affiliation:
Department of Epidemiology, Department of Clinical Microbiology and AIDS Treatment Center, Albany Medical Center, Albany, New York
Hilary Peck
Affiliation:
Department of Epidemiology, Department of Clinical Microbiology and AIDS Treatment Center, Albany Medical Center, Albany, New York
Mara San Antonio
Affiliation:
Department of Epidemiology, Department of Clinical Microbiology and AIDS Treatment Center, Albany Medical Center, Albany, New York
*
Dept. of Epidemiology, Albany Medical Ctr., New Scotland Ave., Albany, NY 12.208
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Abstract

Objective:

To investigate an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) among patients using chromosomal typing of the isolates.

Design:

Comparison of epidemiological and clinical data to endonuclease restriction fragmentation analysis (RFA) of the MRSA isolates associated with an outbreak. Total DNA from the MRSA isolates was restricted with HINDIII and HAEIII for typing.

Setting:

Tertiary care academic medical center.

Methods:

An epidemiological investigation of an outbreak of MRSA among patients in private rooms was evaluated by routine infection control methods. The MRSA isolates from blood cultures of 7 patients and the nares of a nurse were collected during the outbreak. MRSA isolates from 23 patients not associated with the outbreak also were collected. The total DNA of the MRSA isolates were restricted with HINDIII and HAEIII and electrophoresed on 0.6% agarose gels.

Results:

MRSA from 4 of the 7 bacteremic patients and the nurse on the outbreak unit had the same endonuclease restriction pattern. The patients were linked in that they were compromised by severe psoriasis or skin ulcers, were on the unit during the same period, and had oatmeal baths in a common bathtub. Of 50 staff members screened, the nurse was the only person detected as colonized by the strain. The other 3 patients on the unit as well as the 23 patients in other locations not associated with the outbreak had MRSA isolates with different RFA patterns. The use of the bathtub was discontinued and further transmission of MRSA was stopped.

Conclusions:

A comparison of the relatedness of MRSA by RFA demonstrated the uniqueness of the epidemiologically linked isolates and the utility of the RFA technique in the performance of routine infection control investigations.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 13 , Issue 8 , August 1992 , pp. 472 - 476
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1992

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References

1. Cookson, B, Peters, B, Webster, M, Phillips, I, Rahman, M, Noble, W Staff carriage of epidemic methicillin-resistant Staphylococcus aureus . J Clin Microbiol. 1989;27:1471–1476.CrossRefGoogle ScholarPubMed
2. Darouiche, R, Wright, C, Hamill, R, Koza, M, Lewis, D, Markowski, J. Eradication of colonization by methicillin-resistant Staphylococcus aureus by using oral minocycline-rifampin and topical mupirocin. Antimicrob Agents Chemother 1991;35:1612–1615.CrossRefGoogle ScholarPubMed
3. Yu, VL, Goetz, A, Wagener, M, Smith, PB, Rihs, JD, Hanchett, J, Zuravleff, JJ. Staphylococcus aureus nasal carriage and infection in patients on hemodialysis: efficacy of antibiotic prophylaxis. N Engl J Med. 1986;315:91–96.CrossRefGoogle ScholarPubMed
4. Haley, RW. Methicillin-resistant Staphylococcus aureus: do we just have to live with it? Ann Intern Med. 1991;114:162–164.CrossRefGoogle ScholarPubMed
5. Taylor, G, Kirkland, T, Kowalewska-Grochowska, K, Wang, Y. A multistrain cluster of methicillin-resistant Staphylococcus aureus based in a native community. Can J Infect Dis. 1990;1:121–126.Google Scholar
6. Reboli, AC, John, JF Jr, Platt, CG, Cantey, JR. Methicillin-resistant Staphylococcus aureus outbreak at a veterans' affairs medical center: importance of carriage of the organism by hospital personnel. Infect Control Hosp Epidemiol. 1990;11:291–296.CrossRefGoogle Scholar
7. Wenzel, RP, Nettleman, MD, Jones, RN, Pfaller, MA Methicillin-resistant Stuphylococcus aureus: implications for the 1990s and effective control measures. Am J Med. 1991;91(suppl 3B):221S–232S.CrossRefGoogle ScholarPubMed
8. Boyce, JM. Should we vigorously try to contain and control methicillin-resistant Staphylococcus aureus ? Infect Control Hosp Epidemiol. 1991;12:46–54.CrossRefGoogle ScholarPubMed
9. Cohen, SH, Morita, MM, Bradford, M. A seven-year experience with methicillin-resistant Staphylococcus aureus . Am J Med. 1991;91(suppl 3B):233S–237S.CrossRefGoogle ScholarPubMed
10. Bialkowska-Hobrzanska, H, Jaskot, D, Hammerberg, O. Evaluation of restriction endonuclease fingerprinting of chromosomal DNA and plasmid profile analysis for characterization of multiresistant coagulase-negative staphylococci in bacteremic neonates. J Clin Microbiol. 1990;28:269–275.CrossRefGoogle ScholarPubMed
11. Zuccarelli, AJ, Roy, I, Harding, GP,Couperas, JJ. Diversity and stability of restriction enzyme profiles of plasmid DNA from methicillin-resistant Staphylococcus aureus . J Clin Microbiol. 1990; 28:97–102.CrossRefGoogle ScholarPubMed
12. Antimicrobial Disk Susceptibility Tests. M2-A4. 4th ed. Villanova, PA: National Committee for Clinical Laboratory Standards; 1990.Google Scholar
13. Linnemann, CC Jr, Moore, P,Staneck, JL, Pfaller, MA. Reemergence of epidemic methicillin-resistant Stuphylococcus aureus in a general hospital associated with changing staphylococcal strains. Am J Med. 1991;91(suppl 3B):238S–244S.CrossRefGoogle Scholar
14. Jaffe, D, May, LP,Sanchez, M, Moy, J. Staphylococcal sepsis in HIV antibody-seropsitive patients. J Am Acad Dermatol. 1991;24:970–972.CrossRefGoogle ScholarPubMed
15. Mulligan, ME, Arbeit, RD. Epidemiologic and clinical utility of typing systems for differentiating among strains of methicillin-resistant Staphylococcus aureus. Infect Control Hosp Epidemiol. 1991:12:28.CrossRefGoogle ScholarPubMed