title: Clonal spread of Staphylococcus aureus with reduced susceptibility to oxacillin in a dermatological hospital unit.
abstract: In November 2000, we became aware of isolates of Staphylococcus aureus with borderline resistance to oxacillin (BORSA) from patients in the Department of Dermatology, Aarhus University Hospital. The objective was to describe the isolates phenotypically and genotypically and to assess possible transmission routes in order to intervene and prevent further spread. Clonality of the isolates was confirmed by pulsed field gel electrophoresis. Several breaches in infection control procedures were revealed suggesting both direct and indirect transmission between patients. Defective skin barriers, high carrier rates of S. aureus in dermatological patients and high consumption rates of dicloxacillin in the department might facilitate transmission. Following improvement of the general infection control measures, and after reassessment of the antibiotic policy in the department, the outbreak has disappeared.
authors.affiliation: Department of Clinical Microbiology, Aarhus University Hospital, Aarhus, Denmark. mkt@dadlnet.dk
authors.forename: Marianne Kragh
authors.initials: MK
authors.lastname: Thomsen
authors.forename: Mads
authors.initials: M
authors.lastname: Rasmussen
authors.forename: Kurt
authors.initials: K
authors.lastname: Fuursted
authors.forename: Henrik
authors.initials: H
authors.lastname: Westh
authors.forename: Lisbeth Nørum
authors.initials: LN
authors.lastname: Pedersen
authors.forename: Mette
authors.initials: M
authors.lastname: Deleuran
authors.forename: Jens Kjølseth
authors.initials: JK
authors.lastname: Møller
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission*; D003718:Denmark / Q000453:epidemiology; D003880:Dermatology; D004196:Disease Outbreaks; D024881:Drug Resistance, Bacterial / Q000235:genetics*; D005260:Female; D006757:Hospital Units; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010068:Oxacillin / Q000494:pharmacology* / Q000627:therapeutic use; D013207:Staphylococcal Skin Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission*; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D010068:Oxacillin