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Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
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Prolonged outbreak of Staphylococcus aureus surgical site infection traced to a healthcare worker with psoriasis

S A Crusz1, C Yates1, S Holden1

  • 1Department of Clinical Microbiology, Nottingham University Hospital, Nottingham, UK.

The Journal of Hospital Infection
|December 4, 2013
PubMed
Abstract

Insights

A healthcare worker with psoriasis caused a surgical site infection outbreak of methicillin-sensitive Staphylococcus aureus (MSSA). This highlights the risk of skin conditions in healthcare workers and the need for screening.

Area of Science:

  • Infectious Disease Epidemiology
  • Microbiology
  • Public Health

Background:

  • Meticillin-sensitive Staphylococcus aureus (MSSA) is a common cause of surgical site infections (SSIs).
  • Point-source outbreaks of MSSA SSIs are infrequently identified, necessitating further investigation into transmission dynamics.

Observation:

  • An outbreak of MSSA resistant to fusidic acid (MSSA FusR) occurred in a thoracic surgical unit.
  • Investigation identified 19 patients with MSSA FusR SSI over 16 months, linked to a single healthcare worker (HCW) carrier.

Findings:

  • Molecular typing confirmed isolates belonged to the same lineage.
  • A nurse with psoriasis was identified as the carrier of the outbreak strain, with significant patient exposure.
  • The outbreak ceased after ward cleaning and the HCW's removal from clinical duties.

Implications:

  • Healthcare workers with significant skin conditions, such as psoriasis, may pose an infection risk in surgical settings.
  • MSSA FusR may serve as an indicator for strains associated with skin conditions.
  • Occupational health teams should consider screening HCWs with dermatitis for potential infection risks.
Keywords:
Fusidic acid resistanceHealthcare workersMeticillin-sensitive Staphylococcus aureusPsoriasisSurgical site infectionThoracic

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