[The spread of a 'Dutch' methicillin-resistant Staphylococcus aureus strain]

Following isolation of a methicillin-resistant Staphylococcus aureus (MRSA) in a patient subjected to amputation below the knee because of a vasculopathy, further investigations were carried out. Nose, throat and wound cultures were taken from staff and patients who had had contact with the index patient. After taking inventory cultures and cleansing of the two wards involved, these wards were quarantined. The bacterial strain was characterized using microbiological standard methods. The MRSA was encountered in a total of nine patients and two nurses. An infection due to this MRSA was found in two patients and one nurse. Eradication in the hospital was successful. MRSA with the same phage type was found in one nurse and one patient in two nearly hospitals and in one patient in a nearby city. Anamnestically, there had been no contact between them. Tracing this sort of outbreak in time is not possible with the current preventive MRSA policy because there are no demonstrable risk groups for a MRSA occurring in the Netherlands. Routine checking for MRSA carriership among nursing personnel and long-staying surgical patients is a possibility to detect spread of this MRSA. It appears advisable to take restrictive measures even against this S. aureus with restricted resistance, because neither penicillins nor cephalosporins are efficacious. In general, more attention should be given to prevention of nosocomial transmission of S. aureus.