Use of 0.3% triclosan (Bacti-Stat) to eradicate an outbreak of methicillin-resistant Staphylococcus aureus in a neonatal nursery.
BACKGROUND
Once established in an institution, methicillin-resistant Staphylococcus aureus (MRSA) outbreaks have proved difficult to eradicate, despite intensive infection control measures. This report describes the nosocomial infection with MRSA of 22 male infants in a neonatal nursery during a 7-month period and the infection control procedures that effectively brought this outbreak under control and eliminated recurrence for more than 3 1/2 years.


METHODS
After a single index case of bullous impetigo caused by MRSA in a neonate discharged from the nursery 2 weeks previously, an additional 18 cases of MRSA skin infections were clustered in a 7-week period. Aggressive infection control measures were instituted, including changes in umbilical cord care, circumcision procedures, diapers, handwashing, gloves, gowns, linens, disinfection, placement in cohorts of neonates and staff, surveillance, and monitoring.


RESULTS
These measures were not effective in slowing the outbreak. The single additional measure of changing handwashing and bathing soap to a preparation containing 0.3% triclosan (Bacti-Stat) was associated with the immediate termination of the acute phase of the MRSA outbreak.


CONCLUSIONS
The nursery has remained free of MRSA for more than 3 1/2 years, attesting to the success of our program.
Zafar
A B
AB
Department of Infection Control, Arlington Hospital, VA 22205, USA.
Butler
R C
RC
Reese
D J
DJ
Gaydos
L A
LA
Mennonna
P A
PA
D001431:Bacteriological Techniques; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control*; D004196:Disease Outbreaks / Q000517:prevention & control*; D017408:Guidelines as Topic; D006235:Hand Disinfection; D006801:Humans; D007169:Impetigo / Q000453:epidemiology / Q000382:microbiology; D007231:Infant, Newborn; D017053:Infection Control / Q000379:methods*; D008297:Male; D016106:Methicillin Resistance; D009725:Nurseries, Hospital; D013211:Staphylococcus aureus / Q000187:drug effects*; D014260:Triclosan / Q000494:pharmacology*; D014768:Virginia / Q000453:epidemiology
D014260:Triclosan