title: Multiclonal methicillin-resistant Staphylococcus aureus (MRSA) outbreak and its control after use of the Veterans Affairs (VA) MRSA bundle in a VA long-term care facility, 2004-2014.
abstract: A multiclonal methicillin-resistant Staphylococcus aureus (MRSA) outbreak with 91 infections occurred in our Veterans Affairs (VA) community living center over 46 months. Both similar and unique strains were shown by repetitive polymerase chain reaction to contribute to the outbreak, including 1 strain causing infections over a 33-month period. Most infections were soft tissue infections (67%). For 21 months after the initiation of the VA MRSA bundle, no infections were identified, and low rates of infection have been sustained an additional 4 years. The average annual rate of MRSA infection decreased by 62% (P < .001) from 0.6 per 1,000 resident days for 4 years prior to the bundle implementation to 0.09 per 1,000 resident days for 4 years after the bundle implementation.
authors.affiliation: G.V. "Sonny" Montgomery Veterans Affairs (VA) Medical Center, Jackson MS; Univeristy of Mississippi Medical Center, Jackson, MS. Electronic address: risa.webb@va.gov.
authors.forename: Risa M
authors.initials: RM
authors.lastname: Webb
authors.affiliation: G.V. "Sonny" Montgomery Veterans Affairs (VA) Medical Center, Jackson MS.
authors.forename: Carmelita
authors.initials: C
authors.lastname: Denton
authors.affiliation: G.V. "Sonny" Montgomery Veterans Affairs (VA) Medical Center, Jackson MS.
authors.forename: Emily
authors.initials: E
authors.lastname: Spruill
authors.affiliation: G.V. "Sonny" Montgomery Veterans Affairs (VA) Medical Center, Jackson MS.
authors.forename: Gay
authors.initials: G
authors.lastname: Henson
authors.affiliation: G.V. "Sonny" Montgomery Veterans Affairs (VA) Medical Center, Jackson MS.
authors.forename: Lisa
authors.initials: L
authors.lastname: Bruce
authors.affiliation: Central Arkansas Veterans Health Care System, Little Rock, AK.
authors.forename: Gail L
authors.initials: GL
authors.lastname: Woods
authors.affiliation: G.V. "Sonny" Montgomery Veterans Affairs (VA) Medical Center, Jackson MS.
authors.forename: Andrea
authors.initials: A
authors.lastname: Swiatlo
authors.affiliation: G.V. "Sonny" Montgomery Veterans Affairs (VA) Medical Center, Jackson MS.
authors.forename: Erica D
authors.initials: ED
authors.lastname: Walker
authors.affiliation: G.V. "Sonny" Montgomery Veterans Affairs (VA) Medical Center, Jackson MS.
authors.forename: Chere
authors.initials: C
authors.lastname: Peel
authors.affiliation: Univeristy of Mississippi Medical Center, Jackson, MS.
authors.forename: Donna
authors.initials: D
authors.lastname: Sullivan
mesh_terms: D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D004196:Disease Outbreaks; D018562:Disease Transmission, Infectious / Q000517:prevention & control; D014644:Genetic Variation; D006801:Humans; D017053:Infection Control / Q000379:methods; D008134:Long-Term Care; D055624:Methicillin-Resistant Staphylococcus aureus / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification*; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D014728:Veterans
keywords: MRSA bundle; MRSA strain identification; Methicillin-resistant Staphylococcus aureus; long-term care facility