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Methicillin-resistant Staphylococcus aureus: report of an outbreak in a London teaching hospital
G J Duckworth1, J L Lothian, J D Williams
1Department of Medical Microbiology, London Hospital Medical College.
Abstract:
An outbreak with a strain of methicillin-resistant Staphylococcus aureus began in The London Hospital in 1982 and continues to be associated with significant morbidity and mortality. This particular strain, termed epidemic methicillin-resistant S. aureus, is recognized by its characteristic antibiogram, phage-type and plasmid profile. In this outbreak various means of control have been attempted. Sideroom isolation did not curtail spread of the organism and containment was only achieved with the combination of extended screening, mupirocin for treatment of carriage and the use of an isolation ward.
Insights
An epidemic strain of methicillin-resistant Staphylococcus aureus (MRSA) caused significant illness and death starting in 1982. Containment required screening, mupirocin treatment, and isolation wards, as room isolation alone was ineffective.
Area of Science:
- Infectious Diseases
- Microbiology
- Epidemiology
Background:
- A persistent outbreak of a specific methicillin-resistant Staphylococcus aureus (MRSA) strain began in 1982 at The London Hospital.
- This MRSA strain, identified by unique antibiogram, phage-type, and plasmid profile, has led to considerable morbidity and mortality.
Purpose of the Study:
- To evaluate the effectiveness of different control measures against an epidemic MRSA strain.
- To identify strategies for successful containment of MRSA outbreaks in a hospital setting.
Main Methods:
- The study details attempts to control the MRSA outbreak using various infection control interventions.
- Methods included sideroom isolation, extended patient screening, mupirocin treatment for nasal carriage, and the use of a dedicated isolation ward.
Main Results:
- Sideroom isolation alone proved insufficient in limiting the spread of the MRSA strain.
- Effective containment was achieved only through a comprehensive strategy combining extended screening, mupirocin treatment, and isolation ward utilization.
Conclusions:
- Standard isolation precautions were inadequate for controlling this epidemic MRSA strain.
- A multi-faceted approach including aggressive screening, targeted antimicrobial treatment (mupirocin), and dedicated isolation facilities is crucial for MRSA outbreak containment.