title: An outbreak of community-associated methicillin-resistant Staphylococcus aureus infection in a boarding school in Hong Kong Special Administrative Region (China).
abstract: BACKGROUND
  In November 2012, an outbreak of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) skin and soft tissue infections affecting students at a boarding school in Hong Kong Special Administrative Region (China) was detected.
  
  
  METHODS
  A case was defined as any student or staff notified with MRSA infection from 25 October 2012 to 5 July 2013 with the clinical isolate being of staphylococcal cassette chromosome mec type IV or V and positive for Panton-Valentine leukocidin gene. We conducted field investigations, advised on control measures and enhanced surveillance for skin and soft tissue infections at the school. Decolonization therapies were offered to all cases and contacts, and carrier screening was conducted.
  
  
  RESULTS
  There were five cases; two (40%) were hospitalized and three (60%) required surgical treatments. Initial screening comprised 240 students and 81 staff members. Overall, four cases (80%) plus eight other students (3.3%) were carriers, with eight of 12 (66.7%) from the same dormitory. All staff members screened negative. After intensified control measures, the number of students screened positive for CA-MRSA decreased from nine to one with no more cases identified in the school.
  
  
  CONCLUSIONS
  Identification of carriers, decolonization therapy, monitoring of cases and contacts and strengthening of environmental and personal hygiene were control measures that helped contain this CA-MRSA outbreak in a boarding school in Hong Kong Special Administrative Region (China).
authors.affiliation: Surveillance and Epidemiology Branch, Centre for Health Protection, Department of Health, Hong Kong (China). ; Field Epidemiology Training Programme, Hong Kong (China).
authors.forename: Wong
authors.initials: W
authors.lastname: Miu-ling
authors.affiliation: Surveillance and Epidemiology Branch, Centre for Health Protection, Department of Health, Hong Kong (China). ; Field Epidemiology Training Programme, Hong Kong (China).
authors.forename: Poon
authors.initials: P
authors.lastname: Kwok-ming
authors.affiliation: Surveillance and Epidemiology Branch, Centre for Health Protection, Department of Health, Hong Kong (China).
authors.forename: Wan
authors.initials: W
authors.lastname: Yuen-kong
authors.affiliation: Surveillance and Epidemiology Branch, Centre for Health Protection, Department of Health, Hong Kong (China).
authors.forename: Chuang
authors.initials: C
authors.lastname: Shuk-Kwan
authors.affiliation: Surveillance and Epidemiology Branch, Centre for Health Protection, Department of Health, Hong Kong (China).
authors.forename: Kwok
authors.initials: K
authors.lastname: Lai-key
authors.affiliation: Surveillance and Epidemiology Branch, Centre for Health Protection, Department of Health, Hong Kong (China).
authors.forename: Pak
authors.initials: P
authors.lastname: Sik-on
mesh_terms: D000293:Adolescent; D001427:Bacterial Toxins / Q000235:genetics; D002353:Carrier State / Q000453:epidemiology / Q000382:microbiology; D017714:Community-Acquired Infections / Q000453:epidemiology* / Q000382:microbiology; D004196:Disease Outbreaks; D005098:Exotoxins / Q000235:genetics; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D007956:Leukocidins / Q000235:genetics; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000235:genetics; D012574:Schools; D018461:Soft Tissue Infections / Q000453:epidemiology* / Q000382:microbiology; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D013207:Staphylococcal Skin Infections / Q000453:epidemiology* / Q000382:microbiology
chemical_list: D001427:Bacterial Toxins; D005098:Exotoxins; D007956:Leukocidins; C078284:Panton-Valentine leukocidin
references.citation: Int J Antimicrob Agents. 2011 Jul;38(1):2-8
references.pmid: 21397461
references.citation: J Athl Train. 2006 Apr-Jun;41(2):141-5
references.pmid: 16791297
references.citation: Lancet. 2010 May 1;375(9725):1557-68
references.pmid: 20206987
references.citation: Infect Control Hosp Epidemiol. 2011 Oct;32(10):1048-50
references.pmid: 21931262
references.citation: J Infect. 2012 May;64(5):494-9
references.pmid: 22366206
references.citation: Hong Kong Med J. 2009 Dec;15 Suppl 9:9-11
references.pmid: 20393217
references.citation: J Antimicrob Chemother. 2011 May;66(5):1061-9
references.pmid: 21393157