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Gentamicin-methicillin-resistant Staphylococcus aureus: epidemiology and containment of an outbreak
Abstract:
An outbreak of gentamicin-methicillin-resistant Staphylococcus aureus (gentamicin-resistant MRSA) which occurred during 1983-84 at the Whittington Hospital, London, is described. This involved a total of 40 patients and staff and was largely confined to a urology ward. Seventeen of the patients had catheter-associated infections, 11 had wound infections and five had simultaneous infections of the urine and wound. Six members of staff and one patient were colonized with gentamicin-resistant MRSA. Vigorous and extensive infection control methods were carried out together with the use of a topical antibacterial nasal cream, mupirocin (pseudomonic acid). Seventeen patients and staff were treated with this agent and all were cleared of the original gentamicin-resistant MRSA. Sixteen patients who were not treated with mupirocin were discharged home still carrying the epidemic strain. Sporadic cases of gentamicin-resistant MRSA still occur at infrequent intervals.
Insights
An outbreak of gentamicin-methicillin-resistant Staphylococcus aureus (MRSA) was controlled using mupirocin nasal cream. This topical treatment successfully eradicated MRSA in 17 patients and staff, preventing further spread.
Area of Science:
- Infectious Diseases
- Microbiology
- Hospital Epidemiology
Background:
- An outbreak of gentamicin-methicillin-resistant Staphylococcus aureus (gentamicin-resistant MRSA) occurred at Whittington Hospital, London, between 1983-84.
- The outbreak primarily affected a urology ward, involving 40 patients and staff.
Purpose of the Study:
- To describe the outbreak of gentamicin-resistant MRSA.
- To evaluate the effectiveness of infection control measures and mupirocin treatment.
Main Methods:
- Detailed investigation of the outbreak, including patient and staff infections and colonization.
- Implementation of rigorous infection control protocols.
- Treatment of 17 infected/colonized individuals with topical mupirocin nasal cream.
Main Results:
- Seventeen patients had infections (catheter-associated, wound, or combined).
- Six staff members and one patient were colonized with gentamicin-resistant MRSA.
- All 17 individuals treated with mupirocin were cleared of the organism, while 16 untreated patients remained colonized.
Conclusions:
- Mupirocin nasal cream was effective in eradicating gentamicin-resistant MRSA in patients and staff.
- Prompt and extensive infection control measures are crucial during MRSA outbreaks.
- Untreated colonized individuals can continue to carry and potentially spread the epidemic strain.