title: An outbreak of a multiresistant methicillin-susceptible Staphylococcus aureus (MR-MSSA) strain in a burn centre: the importance of routine molecular typing.
abstract: Here we report an outbreak among 17 patients caused by a single strain of a multiresistant methicillin-susceptible Staphylococcus aureus (MR-MSSA) in a burn centre. The MR-MSSA strains were resistant to penicillin, ciprofloxacin, erythromycin, clindamycin and co-trimoxazole. Further analysis showed an increased prevalence of MR-MSSA carriership in S. aureus colonized patients admitted to the burn centre, from 0% in 2005 (0/118), 3.3% in 2006 (4/121), 6.1% in 2007 (6/99), to 7.8% in 2008 (7/90). Molecular typing with amplified fragment length polymorphism showed that all MR-MSSA isolates derived from burn centre patients had a unique genotype, and was different compared to isolates derived from other hospital patients. All healthcare workers (HCWs) who worked in the burn centre during the outbreak were screened for nasal carriage with MR-MSSA. One HCW tested positive for a genotype of MR-MSSA that was indistinguishable from the genotype found in samples of the burned patients. No new cases of MR-MSSA colonization or infection were identified after the colonized HCW stopped working at the burn centre. The routine practice of molecular typing of collected S. aureus strains from both patients and HCWs will help to detect nosocomial spread in a burn centre, and opens the possibility of a rapid, almost pre-emptive response.
authors.affiliation: Regional Laboratory of Public Health Haarlem, Boerhaavelaan 26, 2035 RC, Haarlem, The Netherlands.
authors.forename: S A
authors.initials: SA
authors.lastname: Boers
authors.forename: I
authors.initials: I
authors.lastname: van Ess
authors.forename: S M
authors.initials: SM
authors.lastname: Euser
authors.forename: R
authors.initials: R
authors.lastname: Jansen
authors.forename: F R H
authors.initials: FR
authors.lastname: Tempelman
authors.forename: B M W
authors.initials: BM
authors.lastname: Diederen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002053:Burn Units; D002648:Child; D002675:Child, Preschool; D004269:DNA, Bacterial / Q000032:analysis; D004196:Disease Outbreaks; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D016106:Methicillin Resistance / Q000235:genetics*; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial