[An outbreak of methicillin-resistant Staphylococcus aureus infection in a maternity ward].
BACKGROUND
Staphylococcus aureus is a frequent cause of serious infections. Methicillin-resistant S. aureus (MRSA) are resistant to almost all types of beta-lactam antibiotics and therefore represent a substantial medical problem.


METHODS
In April 2006, the Department of Obstetrics at the Asker and Baerum hospital had an outbreak of MRSA that affected four newborns. The source for the infection was sought among family members, other patients and employees, and eradication was attempted.


RESULTS
An employee was identified as the probable infectious source. Subsequent investigation identified 13 individuals infected by the same MRSA clone, which was Panton-Valentine-leukocidin (PVL) positive and therefore clearly a pathogen. 10 of the patients had MRSA disease, with 21 months between the first and the last identified case. For 5 of 13 patients MRSA was still detectable after the first attempt of eradication. For 2 patients, including one of the newborns, eradication has so far been unsuccessful and a third patient has acquired a new abscess after one year.


CONCLUSIONS
Issues connected to MRSA-screening of close contacts and eradication are resource-demanding and require careful consideration of strategy, especially for small children and families with chronic MRSA carriers. Updated detailed national guidelines for MRSA management are needed.
Jenum
Pål A
PA
Seksjon for medisinsk mikrobiologi, Laboratoriesenteret, Sykehuset Asker og Baerum, 1309 Rud. pal.jenum@sabhf.no
Walberg
Mette
M
Rønning
Else Johanne
EJ
Kristoffersen
Marit
M
D016358:Contact Tracing; D004196:Disease Outbreaks / Q000517:prevention & control; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D016106:Methicillin Resistance; D009664:Norway / Q000453:epidemiology; D009775:Obstetrics and Gynecology Department, Hospital; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000382:microbiology / Q000517:prevention & control; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000635:transmission; D013211:Staphylococcus aureus