title: A hospital-acquired outbreak of methicillin-resistant Staphylococcus aureus infection initiated by a surgeon carrier.
abstract: Methicillin-resistant Staphylococcus aureus (MRSA) has become an important hospital-acquired pathogen, infection with which often leads to major morbidity and mortality. The principal mode of transmission for MRSA is transfer of the organism from a carrier or infected patient to uninfected patients by the hands or clothing of staff. From January 16 1997 to April 2 1997, five patients who had undergone open-heart surgery in a hospital located in northern Taiwan, developed surgical wound infections and mediastinitis caused by MRSA. All patients were hospitalized in two adjacent surgical intensive care units (ICUs) following their respective operations. Consequently, the hospital's infection control team commenced investigation of the outbreak. Pulsed-field gel electrophoresis (PFGE) has been shown to be a good technique for epidemiological typing. By analysing cultures taken from staff by PFGE, it was demonstrated that this outbreak was most likely to be initiated by a surgeon with MRSA carriage. After elimination of the carrier state using topical mupirocin treatment, the outbreak was controlled without further incident.
authors.affiliation: Section of Infectious Diseases, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. sc4030@ha.mc.ntu.edu.tw
authors.forename: J T
authors.initials: JT
authors.lastname: Wang
authors.forename: S C
authors.initials: SC
authors.lastname: Chang
authors.forename: W J
authors.initials: WJ
authors.lastname: Ko
authors.forename: Y Y
authors.initials: YY
authors.lastname: Chang
authors.forename: M L
authors.initials: ML
authors.lastname: Chen
authors.forename: H J
authors.initials: HJ
authors.lastname: Pan
authors.forename: K T
authors.initials: KT
authors.lastname: Luh
mesh_terms: D000293:Adolescent; D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002353:Carrier State / Q000382:microbiology / Q000517:prevention & control / Q000635:transmission*; D002648:Child; D003428:Cross Infection / Q000382:microbiology / Q000517:prevention & control / Q000635:transmission*; D004196:Disease Outbreaks / Q000517:prevention & control / Q000706:statistics & numerical data*; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D006801:Humans; D017053:Infection Control / Q000379:methods; D017757:Infectious Disease Transmission, Professional-to-Patient / Q000379:methods* / Q000517:prevention & control; D008297:Male; D008480:Mediastinitis / Q000382:microbiology / Q000517:prevention & control; D008505:Medical Staff, Hospital; D016106:Methicillin Resistance; D008875:Middle Aged; D013203:Staphylococcal Infections / Q000382:microbiology / Q000517:prevention & control / Q000635:transmission*; D013211:Staphylococcus aureus; D013530:Surgical Wound Infection / Q000382:microbiology / Q000517:prevention & control / Q000635:transmission*; D013624:Taiwan