Hospital transmission of community-acquired methicillin-resistant Staphylococcus aureus among postpartum women.
Infections caused by community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) are being increasingly observed in patients who lack traditional risk factors. We described 8 postpartum women who developed skin and soft-tissue infections caused by MRSA at a mean time of 23 days (range, 4-73 days) after delivery. Infections included 4 cases of mastitis (3 of which progressed to breast abscess), a postoperative wound infection, cellulitis, and pustulosis. The outbreak strains were compared with the prototype CA-MRSA strain MW2 and found to be indistinguishable by pulsed-field gel electrophoresis. All were spa type 131, all contained the staphylococcal chromosomal cassette mec type IV, and all expressed Panton-Valentine leukocidin and staphylococcal enterotoxins C and H. The route of transmission was not discovered: the results of surveillance cultures of samples obtained from employees of the hospital, the hospital environment, and newborns were negative for the outbreak strain. We report that MW2, which was previously limited to the midwestern United States, has spread to the northeastern United States and has become a health care-associated pathogen.
Department of Pediatrics, Columbia University, New York, New York 10032, USA. LS5@columbia.edu
Lisa
L
Saiman
Mary
M
O'Keefe
Philip L
PL
Graham
Fann
F
Wu
Battouli
B
Saïd-Salim
Barry
B
Kreiswirth
Anita
A
LaSala
Patrick M
PM
Schlievert
Phyllis
P
Della-Latta
D000900:Anti-Bacterial Agents / Q000494:pharmacology; D016022:Case-Control Studies; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission*; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission*; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D016106:Methicillin Resistance / Q000502:physiology*; D008826:Microbial Sensitivity Tests; D049590:Postpartum Period; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission*; D013211:Staphylococcus aureus / Q000187:drug effects*; D037521:Virulence Factors / Q000032:analysis
D000900:Anti-Bacterial Agents; D037521:Virulence Factors