Healthcare worker-related MRSA cluster in a German neonatology level III ICU: a true European story

Area of Science:

• Infectious Diseases
• Microbiology
• Epidemiology

Background:

• Methicillin-resistant Staphylococcus aureus (MRSA) poses a significant threat in healthcare settings, particularly to vulnerable populations like neonates.
• Identifying the source of MRSA outbreaks is crucial for effective infection control.

Purpose of the Study:

• To investigate the source of an MRSA colonization cluster in eight neonates at an intensive care unit (ICU).
• To characterize the molecular epidemiology of the MRSA strain involved.
• To assess the role of healthcare workers (HCWs) in the transmission of MRSA.

Main Methods:

• Molecular strain characterization using spa-typing and pulsed-field gel electrophoresis (PFGE).
• Screening of neonates, parents, and hospital staff for MRSA colonization.
• Environmental sampling to rule out other sources of transmission.

Main Results:

• A rare spa-type t127 MRSA strain was identified in eight colonized neonates.
• Environmental and parental screening yielded negative results.
• MRSA colonization was detected in 18% of recently employed Romanian HCWs, with 14% sharing the same molecular strain type as the index case.
• Successful decolonization of HCW carriers halted new patient cases.

Conclusions:

• MRSA-colonized HCWs can serve as a significant source for hospital-acquired transmission, especially in ICUs.
• HCWs from high endemic countries may be at higher risk for colonization and pose a potential risk to patients.
• Implementation of universal screening for new employees is essential for infection control management.