title: Healthcare worker-related MRSA cluster in a German neonatology level III ICU: a true European story.
abstract: Here we investigated a cluster of eight newly Methicillin-resistant Staphylococcus aureus (MRSA)-colonized neonates at an ICU, and present data on molecular strain characterization as well as the source identification process in which we analyze the impact of MRSA-colonized HCWs. Molecular strain characterization revealed a unique pattern which was identified as spa-type t 127--an extremely rare strain type in Germany. Environmental sampling and screening of parents of colonized neonates proved negative. However, staff screening identified one healthcare worker (HCW; 1/134) belonging to a group of recently employed Romanian HCWs who was colonized with the spa 127 strain. Subsequent screening also detected MRSA in 9/51 Romanian HCWs (18%) and 7/9 (14% of all) isolates showed the same molecular pattern as the index case (spa/PFGE type). All carriers were successfully decolonized, after which no new patient cases occurred. As a result, we have now implemented a universal screening programme of all new employees as part of our infection control management strategy. MRSA-colonized HCWs can act as a source for in hospital transmission. Since HCWs from high endemic countries are particular prone to being colonized, they may pose a risk to patients.
authors: Department of Infection Control and Infectious Diseases, RWTH Aachen University Hospital, Aachen, Germany. Electronic address: sscheithauer@ukaachen.de.
authors: S
authors: S
authors: Scheithauer
authors: Department of Pediatrics, Division of Neonatology, RWTH Aachen University Hospital, Aachen, Germany.
authors: S
authors: S
authors: Trepels-Kottek
authors: Department of Infection Control and Infectious Diseases, RWTH Aachen University Hospital, Aachen, Germany.
authors: H
authors: H
authors: Häfner
authors: RWTH Aachen University Hospital, Aachen, Germany.
authors: D
authors: D
authors: Keller
authors: RWTH Aachen University Hospital, Aachen, Germany.
authors: T
authors: T
authors: Ittel
authors: Department of Pediatrics, RWTH Aachen University Hospital, Aachen, Germany.
authors: N
authors: N
authors: Wagner
authors: Department of Pediatrics, Division of Neonatology, RWTH Aachen University Hospital, Aachen, Germany.
authors: K
authors: K
authors: Heimann
authors: Department of Pediatrics, Division of Neonatology, RWTH Aachen University Hospital, Aachen, Germany.
authors: M
authors: M
authors: Schoberer
authors: MVZ Labor Dr. Stein + Kollegen, Mönchengladbach, Germany.
authors: R
authors: R
authors: Schwarz
authors: LDZ, University Hospital, Aachen, Germany.
authors: G
authors: G
authors: Haase
authors: Department of Infection Control and Infectious Diseases, RWTH Aachen University Hospital, Aachen, Germany.
authors: B
authors: B
authors: Waitschies
authors: Department of Pediatrics, Division of Neonatology, RWTH Aachen University Hospital, Aachen, Germany.
authors: T
authors: T
authors: Orlikowsky
authors: Department of Infection Control and Infectious Diseases, RWTH Aachen University Hospital, Aachen, Germany.
authors: S
authors: S
authors: Lemmen
mesh_terms: D000328:Adult; D002353:Carrier State; D003428:Cross Infection / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology / Q000517:prevention & control / Q000635:transmission*; D004196:Disease Outbreaks; D005858:Germany / Q000453:epidemiology; D006282:Health Personnel; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008403:Mass Screening; D055624:Methicillin-Resistant Staphylococcus aureus; D009359:Neonatology; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control / Q000635:transmission*
keywords: Cross transmission; Infection control; Multi resistant bacteria; Neonatology