title: Outbreak in a New York City teaching hospital burn center caused by the Iberian epidemic clone of MRSA.
abstract: During an 18-month period in a burn center (January 1995 through June 1996), 109 single-patient MRSA isolates were identified and 102 isolates (94%) were available for DNA fingerprinting. Ninety-nine isolates (97%) carried the mecA polymorph I and Tn554 type E. Pulsed-field electrophoresis (PFGE) identified 8 patterns, of which 60 isolates were of pattern F2. The I:E:F clonal type and a stable drug multidrug resistant phenotype (sensitivity only to trimethoprim/sulfamethoxazole and vancomycin) indicated that these isolates were closely related to the Iberian clone of MRSA, which is widely spread in Europe. The initial source of I:E:F isolates was sputum 49%, blood 23%, wound 16%, urine 7%, and intravascular catheter tip 5%. Fifty-four percent of patients had smoke inhalation injury, and 51/53 required intubation or tracheostomy. Forty-three isolates were considered invasive (positive blood culture). The overall mortality was 30%. Despite infection control measures, the I:E:F clone continued to be recovered from patients during the 18 months of study. This outbreak is the first known report of the Iberian MRSA clone in the United States.
authors.affiliation: The New York Hospital-Cornell Medical Center, NY 10021, USA.
authors.forename: R B
authors.initials: RB
authors.lastname: Roberts
authors.forename: A M
authors.initials: AM
authors.lastname: Tennenberg
authors.forename: W
authors.initials: W
authors.lastname: Eisner
authors.forename: J
authors.initials: J
authors.lastname: Hargrave
authors.forename: L M
authors.initials: LM
authors.lastname: Drusin
authors.forename: R
authors.initials: R
authors.lastname: Yurt
authors.forename: B N
authors.initials: BN
authors.lastname: Kreiswirth
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002053:Burn Units; D002648:Child; D002675:Child, Preschool; D016172:DNA Fingerprinting; D004196:Disease Outbreaks; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D007223:Infant; D017053:Infection Control; D008297:Male; D016106:Methicillin Resistance / Q000235:genetics; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D013211:Staphylococcus aureus / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*