Outbreak Due to Methicillin- and Rifampin-Resistant Staphylococcus aureus: Epidemiology and Eradication of the Resistant Strain from the Hospital

A methicillin- and rifampin-resistant strain of Staphylococcus aureus was introduced into a university hospital by interstate transfer of an infected surgical patient. An outbreak occurred, and 17 patients became infected or colonized with the epidemic strain. Reservoirs appeared to be patients who...

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Bibliographic Details
Published in:Infection control : IC 1987-01, Vol.8 (1), p.15-23
Main Authors: Bitar, Cynthia M., Mayhall, C. Glen, Lamb, V. Archer, Bradshaw, Thomas J., Spadora, Alice C., Dalton, Harry P.
Format: Article
Language:English
Subjects:
Carrier State - drug therapy
Catheters
Cross Infection - epidemiology
Cross Infection - prevention & control
Disease Outbreaks
Epidemics
Female
Hospital Bed Capacity, 500 and over
Humans
Infections
Instrumentation
Intensive Care Units
Male
Methicillin - pharmacology
Methicillin resistant staphylococcus aureus
Middle Aged
Nasal carriers
Nurses
Nursing
Penicillin Resistance
Personnel, Hospital
Predisposing factors
Retrospective Studies
Rifampin - pharmacology
Staphylococcal Infections - drug therapy
Staphylococcal Infections - epidemiology
Staphylococcal Infections - prevention & control
Staphylococcal Infections - transmission
Staphylococcus aureus
Staphylococcus aureus - drug effects
Staphylococcus aureus - isolation & purification
Vancomycin - therapeutic use
Virginia
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Summary:A methicillin- and rifampin-resistant strain of Staphylococcus aureus was introduced into a university hospital by interstate transfer of an infected surgical patient. An outbreak occurred, and 17 patients became infected or colonized with the epidemic strain. Reservoirs appeared to be patients who were infected or colonized with the resistant S aureus and possibly two nurses who were nasal carriers. The outbreak isolate was likely spread by contact with contaminated hands of personnel. A retrospective case-control study identified tracheostomy, débridement, and irrigation of wounds by power spray and prolonged nasogastric intubation as risk factors for acquisition of the epidemic strain. Analysis of factors by groups indicated that surgical procedures, wound care procedures and instrumentation of the respiratory tract were significantly associated with cases. The nasal carrier state was eradicated in two nurses by topical application of 5% vancomycin. The epidemic strain was eradicated from the hospital 8 months after it was introduced.
ISSN:0195-9417
2327-9451
DOI:10.1017/S0195941700066935