title: An outbreak of methicillin-resistant Staphylococcus aureus in a pediatric hospital--how it got away and how we caught it.
abstract: An outbreak of methicillin-resistant Staphylococcus aureus (MRSA) occurred in a hospital without endemic MRSA, following the transfer of a patient colonized by MRSA from another hospital known to have a problem with endemic MRSA. Despite initial appropriate isolation and therapy to eradicate colonization of the organism, the index child relapsed 10 weeks after the last prior positive culture. Simultaneously, the organism was isolated from two other patients on the same ward, and subsequently at surgery from one child transferred to the neonatal intensive care nursery. Antimicrobial therapy for urinary tract infection likely impaired earlier identification of MRSA in the index case. Suppression with mupirocin rather than eradication may have resulted in inappropriate early discontinuation of infection control precautions. Control of the outbreak and eradication of the organism from all patients was successful after intensive surveillance and control measures, including strict isolation and cohorting. This outbreak suggests that infection control precautions and intensive screening of contacts, as well as positive cases, may be effective for control and eradication of MRSA from health care facilities with recent introduction of an epidemic strain.
authors.forename: L
authors.initials: L
authors.lastname: Romance
authors.forename: L
authors.initials: L
authors.lastname: Nicolle
authors.forename: J
authors.initials: J
authors.lastname: Ross
authors.forename: B
authors.initials: B
authors.lastname: Law
mesh_terms: D002675:Child, Preschool; D003428:Cross Infection / Q000453:epidemiology* / Q000517:prevention & control; D004196:Disease Outbreaks; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D017053:Infection Control / Q000379:methods*; D008350:Manitoba / Q000453:epidemiology; D016106:Methicillin Resistance; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000517:prevention & control