Control of methicillin-resistant Staphylococcus aureus in a pediatric burn unit.
BACKGROUND
Control of methicillin-resistant Staphylococcus aureus (MRSA) is particularly difficult in burn units, which are often cited as sources of hospital-wide MRSA outbreaks. We developed a successful MRSA control program and document here its apparent effectiveness in controlling MRSA transmission in a pediatric burn unit.


METHODS
An MRSA control program that included surveillance culturing, clinician feedback, flexible, site-specific isolation, and a list of known carriers was consistently applied in a pediatric burn unit through a 7-year period. Microbiology reports of MRSA isolates from patients and environmental surfaces and records of all patients from whom MRSA was isolated were reviewed.


RESULTS
During calendar years 1985 through 1991, a total of 991 acutely burned children were admitted to the Boston unit of the Shriners Burns Institute. Forty MRSA cases (4%) were identified. One patient both had MRSA at admission and met our criteria for nosocomial MRSA. Of the remaining 39 patients, 11 had MRSA at admission and 28 had nosocomial MRSA. There were 17 wound infections, two cases of pneumonia, and two bloodstream infections. No deaths were attributed to MRSA sepsis.


CONCLUSIONS
An MRSA control program including surveillance culturing, clinician feedback, flexible, site-specific isolation, and a list of known carriers is associated with a low rate of nosocomial MRSA in a pediatric burn unit.
Sheridan
R L
RL
Surgical Services, Massachusetts General Hospital, Boston.
Weber
J
J
Benjamin
J
J
Pasternack
M S
MS
Tompkins
R G
RG
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001900:Boston; D002053:Burn Units; D002056:Burns / Q000150:complications; D002648:Child; D002675:Child, Preschool; D015169:Colony Count, Microbial; D003428:Cross Infection / Q000517:prevention & control* / Q000635:transmission; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D017053:Infection Control / Q000379:methods; D016106:Methicillin Resistance; D013203:Staphylococcal Infections / Q000382:microbiology / Q000517:prevention & control* / Q000635:transmission; D013211:Staphylococcus aureus / Q000254:growth & development / Q000302:isolation & purification*; D014946:Wound Infection / Q000517:prevention & control* / Q000635:transmission
D000900:Anti-Bacterial Agents