An outbreak of Methicillin-resistant Staphylococcus aureus cutaneous infection in a saturation diving facility

Area of Science:

• Microbiology
• Epidemiology
• Diving Medicine

Background:

• Cutaneous infections, including boils and abscesses, can occur in occupational settings.
• Saturation diving environments present unique challenges for infection control.
• Methicillin-resistant Staphylococcus aureus (MRSA) is a significant public health concern due to its antibiotic resistance.

Purpose of the Study:

• To investigate a molecular epidemiology of a cutaneous tissue infection outbreak among divers.
• To identify the causative agent, transmission dynamics, and source of the MRSA outbreak.
• To provide recommendations for preventing and managing similar infections in diving communities.

Main Methods:

• Isolation and identification of Staphylococcus aureus from skin lesions.
• Antimicrobial susceptibility testing (antibiogram) of isolates.
• Molecular typing using pulse field gel electrophoresis (PFGE) for Methicillin-resistant Staphylococcus aureus (MRSA) strain characterization.

Main Results:

• Staphylococcus aureus was consistently isolated from affected divers.
• All isolates were resistant to penicillin, oxacillin, and erythromycin, but sensitive to clindamycin, tetracycline, trimethoprim-sulfamethoxazole, rifampin, and vancomycin.
• PFGE revealed indistinguishable patterns among MRSA isolates, indicating a common source; a colonized diver was identified as the source, with personal contact as the likely transmission mode.

Conclusions:

• This is the first reported outbreak of Methicillin-resistant Staphylococcus aureus (MRSA) in a saturation diving facility.
• MRSA infection should be suspected in divers with boils unresponsive to standard treatment.
• Implementing strict hygiene protocols and surveillance is crucial for preventing MRSA transmission in diving operations.