Related Experiment Video
Updated: Mar 25, 2026
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
Published on: February 9, 2011
Successful infection control for a vancomycin-intermediate Staphylococcus aureus outbreak in an advanced emergency
1Department of Pharmacy, Kurume University Hospital, Kurume, Japan; Department of Infection Control and Prevention, Kurume University School of Medicine, Kurume, Japan; Division of Infection Control and Prevention, Kurume University Hospital, Kurume, Japan.
Background:
A vancomycin-intermediate Staphylococcus aureus (VISA) (vancomycin minimum inhibitory concentration: 4mg/L) outbreak occurred in an advanced emergency medical service centre [hereafter referred to as the intensive care unit (ICU)] between 2013 and 2014.
Aim:
Our objective was to evaluate the infection control measures that were successful.
Methods:
Seventeen VISA strains were isolated from the sputum of 15 inpatients and the skin of two inpatients. Fourteen VISA strains were recognized as colonization. However, three VISA strains were isolated from the sputum of three inpatients with pneumonia. Environmental cultures were performed and VISA strains were detected in five of 65 sites. Pulsed-field gel electrophoresis (PFGE) and multi-locus sequence typing (MLST) was performed on 21 VISA strains.
Findings:
Molecular typing including PFGE and MLST showed that the patterns of 19 VISA strains were identical and those of the other two VISA strains were possibly related. This meant that a horizontal transmission of VISA strains had occurred in the ICU. In August 2013, the infection control team began interventions. However, new inpatients with VISA strains continued to appear. Therefore, in October 2013, the ICU was partially closed in order to try to prevent further horizontal transmission, and existing inpatients with the VISA strain were isolated. Although new cases quickly dissipated after the partial closure, it took approximately five months to eradicate the VISA outbreak.
Conclusion:
Our data suggest that despite the employment of various other infection control measures, partial closure of the ICU was essential in terminating this VISA outbreak.
Insights
A vancomycin-intermediate Staphylococcus aureus (VISA) outbreak in an ICU was controlled by isolating patients and partially closing the unit. This demonstrates that ICU closure was essential for terminating the VISA spread.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Microbiology
Background:
- An outbreak of vancomycin-intermediate Staphylococcus aureus (VISA) occurred in an intensive care unit (ICU) between 2013 and 2014.
- VISA strains were isolated from both colonized and infected patients, indicating significant transmission within the ICU.
Purpose of the Study:
- To evaluate the effectiveness of infection control measures implemented during a VISA outbreak.
- To identify the key interventions that led to the successful termination of the outbreak.
Main Methods:
- Seventeen VISA strains were isolated from patients (sputum and skin) and environmental sites.
- Molecular typing techniques, including pulsed-field gel electrophoresis (PFGE) and multi-locus sequence typing (MLST), were used to analyze VISA strains.
- Interventions included standard infection control measures, patient isolation, and partial ICU closure.
Main Results:
- Molecular typing confirmed horizontal transmission of VISA within the ICU.
- Initial interventions were insufficient to halt the spread of VISA.
- Partial closure of the ICU, combined with patient isolation, led to the dissipation of new cases.
Conclusions:
- Partial closure of the ICU was a critical factor in eradicating the VISA outbreak.
- A multi-faceted approach, including unit closure, is necessary for controlling challenging hospital-acquired infections.
Related Concept Videos
01:25Clinical Significance of Antibiotic Resistance
01:25Mechanism of Antibiotic Resistance in MRSA
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:29Staphylococcal Skin Infections
01:18Endocarditis III: Medical Management
01:28Antimicrobial Effectiveness