title: Rapid control of an outbreak of Staphylococcus aureus on a neonatal intensive care department using standard infection control practices and nasal mupirocin.
abstract: BACKGROUND
  Staphylococcus aureus is a common pathogen in neonatal intensive care departments, causing significant morbidity, mortality, and cost. Frequently, S aureus outbreaks may last for months or years. After a cluster of 4 clinically significant S aureus infections in a 7-day period in our 35-bed neonatal intensive care department, we immediately introduced standard outbreak control measures. Unique to our approach was the addition of immediate nasal mupirocin treatment of all staff members and selected patients.
  
  
  METHODS
  Patients were screened for S aureus colonization and were cohorted with separate caregivers. S aureus isolates were submitted to a reference laboratory for pulse-field gel electrophoretic typing. Infection control practices were emphasized and education was provided for staff, physicians, and parents of patients. All caregivers and selected patients were treated immediately with nasal mupirocin. Cohorting was maintained until all patients who were colonized or infected were discharged.
  
  
  RESULTS
  A total of 5 patients were found to be infected and 4 of 19 patients tested were found to be colonized during the study period. Patients who were infected were successfully treated. Secondary colonization and infection did not occur after implementation of controls.
  
  
  CONCLUSIONS
  Rapid and comprehensive implementation of standard outbreak controls along with immediate treatment of direct care staff and patients with nasal mupirocin successfully controlled this outbreak within 4 weeks and no further cases have been noted.
authors.affiliation: Infection Control Department, North Memorial Health Care, 3300 Oakdale Avenue N., Robbinsdale, MN 55422-2900, USA.
authors.forename: Richard T
authors.initials: RT
authors.lastname: Lally
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Lanz
authors.forename: Christian G
authors.initials: CG
authors.lastname: Schrock
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004196:Disease Outbreaks / Q000517:prevention & control*; D006801:Humans; D007231:Infant, Newborn; D017053:Infection Control / Q000379:methods; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control; D007363:Intensive Care Units, Neonatal; D008910:Minnesota / Q000453:epidemiology; D016712:Mupirocin / Q000627:therapeutic use*; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000517:prevention & control*
chemical_list: D000900:Anti-Bacterial Agents; D016712:Mupirocin