title: Outbreak among healthy newborns due to a new variant of USA300-related meticillin-resistant Staphylococcus aureus.
abstract: BACKGROUND
  The prevalence of community-associated meticillin-resistant Staphylococcus aureus (CA-MRSA) is increasing throughout the world and is an important cause of skin and soft tissue infection (SSTI) in children and neonates.
  
  
  OBJECTIVE
  To describe the successful control of an outbreak caused by a new strain of CA-MRSA in a newborn nursery.
  
  
  METHODS
  The investigation of the outbreak in July 2012 is reported with the control measures taken. Molecular typing of the MRSA isolates was performed.
  
  
  RESULTS
  An outbreak of SSTI caused by CA-MRSA occurred in a newborn nursery. Six neonates were infected in a one-month period [infection rate: 8.5% (6/71)]. A new variant of CA-MRSA was responsible, which was characterized as USA300-related, Panton-Valentine Leucocidin (PVL) positive, arginine catabolic mobile element (ACME) negative, sequence type 8 (ST8), staphylococcal cassette chromosome mec (SCCmec) type IVa, agr type I and spa type t008. The outbreak among term neonates followed a rapid transmission pattern and was successfully controlled by implementing various outbreak control measures, including universal chlorhexidine bathing.
  
  
  CONCLUSIONS
  This is the first report of a hospital outbreak caused by a USA300-related CA-MRSA clone in Korea. Early recognition and reinforcement of infection control measures are important in decreasing transmission of CA-MRSA in a hospital setting.
authors.affiliation: Department of Paediatrics, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors.forename: H
authors.initials: H
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. Electronic address: eskim@snubh.org.
authors.forename: E S
authors.initials: ES
authors.lastname: Kim
authors.affiliation: Department of Paediatrics, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors.forename: C
authors.initials: C
authors.lastname: Choi
authors.affiliation: Infection Control Office, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors.forename: H
authors.initials: H
authors.lastname: Seo
authors.affiliation: Infection Control Office, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors.forename: M
authors.initials: M
authors.lastname: Shin
authors.affiliation: Department of Nursing, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors.forename: J H
authors.initials: JH
authors.lastname: Bok
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors.forename: J E
authors.initials: JE
authors.lastname: Cho
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors.forename: C J
authors.initials: CJ
authors.lastname: Kim
authors.affiliation: Department of Dermatology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors.forename: J W
authors.initials: JW
authors.lastname: Shin
authors.affiliation: Department of Laboratory Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors.forename: T S
authors.initials: TS
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors.forename: K H
authors.initials: KH
authors.lastname: Song
authors.affiliation: Department of Laboratory Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors.forename: K U
authors.initials: KU
authors.lastname: Park
authors.affiliation: Department of Paediatrics, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors.forename: B I
authors.initials: BI
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea; Infection Control Office, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors.forename: H B
authors.initials: HB
authors.lastname: Kim
mesh_terms: D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D002710:Chlorhexidine / Q000627:therapeutic use; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D004269:DNA, Bacterial / Q000235:genetics; D004196:Disease Outbreaks; D018562:Disease Transmission, Infectious / Q000517:prevention & control; D006801:Humans; D007231:Infant, Newborn; D017053:Infection Control / Q000379:methods; D055624:Methicillin-Resistant Staphylococcus aureus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D058889:Molecular Typing; D056910:Republic of Korea / Q000453:epidemiology; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D037521:Virulence Factors / Q000235:genetics
chemical_list: D000891:Anti-Infective Agents, Local; D004269:DNA, Bacterial; D037521:Virulence Factors; D002710:Chlorhexidine
keywords: Community-associated infection; Disease outbreak; Meticillin-resistant Staphylococcus aureus; Newborn; Panton–Valentine leucocidin