title: Outbreak of a South West Pacific clone Panton-Valentine leucocidin-positive meticillin-resistant Staphylococcus aureus infection in a UK neonatal intensive care unit.
abstract: BACKGROUND
  Panton-Valentine leucocidin-positive meticillin-resistant Staphylococcus aureus (PVL-MRSA) has become a globally common cause of community-acquired infections.
  
  
  OBJECTIVE
  We report an outbreak of PVL-MRSA in a regional neonatal unit in the UK involving three babies and three staff members.
  
  
  METHODS
  Quinolone susceptibility was helpful in identifying potential PVL-MRSA but toxin gene profiling and sequence-based typing were required to distinguish between two PVL-MRSA strains present in the unit.
  
  
  RESULTS
  All three symptomatic babies and two staff carriers, one of whom was symptomatic, were found to be carrying the South West Pacific (SWP) clone of PVL-MRSA (ST30). One of the staff carriers had recently visited the Philippines and was thought to be the source of the outbreak. Control was established using standard infection control procedures but one baby with relapsing MRSA colonization has required more than 100 days in isolation.
  
  
  CONCLUSIONS
  This is the first reported neonatal outbreak associated with the SWP clone in the UK. Our study highlights the potential risk of further introductions of this organism by healthcare staff or patients epidemiologically linked with the Philippines.
authors.affiliation: Clinical Microbiology Service, East Kent Hospitals University NHS Foundation Trust, The William Harvey Hospital, Ashford, Kent, UK.
authors.forename: H
authors.initials: H
authors.lastname: Ali
authors.forename: J Q
authors.initials: JQ
authors.lastname: Nash
authors.forename: A M
authors.initials: AM
authors.lastname: Kearns
authors.forename: B
authors.initials: B
authors.lastname: Pichon
authors.forename: V
authors.initials: V
authors.lastname: Vasu
authors.forename: Z
authors.initials: Z
authors.lastname: Nixon
authors.forename: A
authors.initials: A
authors.lastname: Burgess
authors.forename: D
authors.initials: D
authors.lastname: Weston
authors.forename: J
authors.initials: J
authors.lastname: Sedgwick
authors.forename: G
authors.initials: G
authors.lastname: Ashford
authors.forename: F A
authors.initials: FA
authors.lastname: Mühlschlegel
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001427:Bacterial Toxins / Q000235:genetics*; D002353:Carrier State / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission; D004196:Disease Outbreaks; D018562:Disease Transmission, Infectious / Q000517:prevention & control; D005098:Exotoxins / Q000235:genetics*; D005260:Female; D006282:Health Personnel; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D017053:Infection Control / Q000379:methods; D007363:Intensive Care Units, Neonatal; D007956:Leukocidins / Q000235:genetics*; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000145:classification* / Q000302:isolation & purification / Q000472:pathogenicity*; D008826:Microbial Sensitivity Tests; D017720:Molecular Epidemiology; D058889:Molecular Typing; D010679:Philippines; D015363:Quinolones / Q000494:pharmacology; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission; D014195:Travel; D006113:United Kingdom / Q000453:epidemiology; D037521:Virulence Factors / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D001427:Bacterial Toxins; D005098:Exotoxins; D007956:Leukocidins; C078284:Panton-Valentine leukocidin; D015363:Quinolones; D037521:Virulence Factors