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[Spread and control of a methicillin-resistant Staphylococcus aureus in an academic hospital]
H M Frénay1, C M Vandenbroucke-Grauls, T J Savelkoul
1Afd. Medische Microbiologie en Laboratorium voor Infectieziekten, Academisch Ziekenhuis, Utrecht.
Abstract:
Between December 1988 and March 1989 twelve patients in the Utrecht University Hospital developed an infection with a methicillin-resistant Staphylococcus aureus (MRSA). Twenty other patients and 39 personnel members became colonized with the same MRSA strain. In spite of early isolation measures, progression of this epidemic was probably caused by the extreme degree of contagiousness of the first patient, who had a drug-induced allergic skin eruption. It seems likely that spread occurred via personnel and via a computer tomographic scanner. To contain the epidemic it was necessary to institute a special isolation ward with dedicated personnel. Although several MRSA strains have been introduced in the University Hospital since 1986, the strain we describe here is the only one which spread epidemically.
Insights
An outbreak of methicillin-resistant Staphylococcus aureus (MRSA) infected twelve patients and colonized others at Utrecht University Hospital. Strict isolation measures, including a dedicated ward, were needed to control this highly contagious strain.
Area of Science:
- Infectious Diseases
- Epidemiology
- Microbiology
Context:
- A significant methicillin-resistant Staphylococcus aureus (MRSA) outbreak occurred at Utrecht University Hospital between December 1988 and March 1989.
- The outbreak involved 12 infected patients, 20 colonized patients, and 39 colonized personnel members.
Purpose:
- To describe the epidemiology and control of a unique, highly contagious MRSA strain that caused an epidemic.
- To identify the transmission routes and contributing factors of the MRSA outbreak.
Summary:
- The epidemic strain of MRSA was exceptionally contagious, likely facilitated by the index patient's allergic skin condition.
- Transmission pathways included hospital personnel and a computer tomographic scanner.
- Effective containment required the establishment of a specialized isolation ward with dedicated staff.
Impact:
- This MRSA strain was the only one to spread epidemically among several introduced strains since 1986.
- Highlights the importance of stringent infection control measures for highly transmissible pathogens.
- Demonstrates the challenges in controlling MRSA outbreaks in hospital settings.