An outbreak of infection due to Staphylococcus aureus phage type 52 in a neonatal intensive care unit

Area of Science:

• Medical Microbiology
• Infectious Disease Epidemiology
• Hospital Infection Control

Background:

• An outbreak of penicillin-resistant Staphylococcus aureus phage-type 52 occurred in pediatric wards, predominantly affecting a neonatal intensive care unit (NICU).
• The specific phage type involved demonstrated resistance solely to penicillin, posing a unique challenge for treatment and containment.

Purpose of the Study:

• To describe the epidemiology and clinical presentation of a Staphylococcus aureus phage-type 52 outbreak in a NICU setting.
• To identify the primary sites of colonization and the methods used to successfully contain the outbreak.

Main Methods:

• Retrospective analysis of infection and colonization cases during the outbreak period.
• Identification of Staphylococcus aureus phage-type 52 through microbiological typing.
• Implementation of infection control measures, including staff nasal decolonization.

Main Results:

• The outbreak involved 86 infants, with common manifestations including conjunctivitis, wound infections, omphalitis, and otitis externa.
• Seven percent of affected infants developed septicaemia, and 6% were colonized, with the umbilicus being the most frequent carriage site.
• Successful containment was achieved through staff nasal carriage eradication and adherence to standard infection control protocols.

Conclusions:

• Penicillin-resistant Staphylococcus aureus phage-type 52 can cause significant morbidity in neonates, including severe infections like septicaemia.
• Targeted eradication of nasal carriage in healthcare workers is a critical component in controlling such outbreaks.
• Standard infection control measures, combined with decolonization strategies, are effective in managing Staphylococcus aureus outbreaks in NICUs.