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[An outbreak of methicillin-resistant Staph aureus in a nursing home]
P G Peerbooms1, W Kelly, C T van Doorenmaalen
1Gemeentelijke Geneeskundige & Gezondheidsdienst, Amsterdam.
Abstract:
The introduction of methicillin-resistant Staphylococcus aureus (MRSA) in an Amsterdam nursing home (312 beds) by a patient discharged from a local hospital, the spread of this strain to other residents and staff of the nursing home and the actions taken to prevent this spread are described. During the period when this MRSA strain was circulating residents and staff members were checked periodically for presence of MRSA. In spite of all preventive measures as implemented in Dutch hospitals (including isolation of infected residents) additional residents (in a total of 8) and staff members acquired the MRSA strain. Relaxation of the precautions (no more isolation) and continued instruction of the members of the staff was attended by a decrease of further contamination. Four of 8 residents died while being colonised or infected. The course of this epidemic illustrates that limited precautions and proper training of staff in hygiene can restrict spread of MRSA in nursing homes.
Insights
Methicillin-resistant Staphylococcus aureus (MRSA) spread in a nursing home despite isolation. Relaxed precautions and staff hygiene training reduced further contamination, showing limited measures can control MRSA.
Area of Science:
- Infectious Diseases
- Epidemiology
- Public Health
Context:
- A nursing home in Amsterdam experienced an outbreak of methicillin-resistant Staphylococcus aureus (MRSA).
- The MRSA strain was introduced by a patient transferred from a local hospital.
- The facility has 312 beds.
Purpose:
- To describe the introduction and spread of MRSA in a nursing home setting.
- To detail the control measures implemented and their effectiveness.
- To illustrate the impact of limited precautions and staff training on MRSA containment.
Summary:
- MRSA was introduced by a patient, leading to spread among residents and staff.
- Despite hospital-standard preventive measures, including isolation, 8 additional residents and staff acquired MRSA.
- Relaxing isolation precautions and reinforcing staff hygiene training led to decreased MRSA transmission.
Impact:
- The outbreak resulted in 4 deaths among the 8 additionally infected residents.
- The study demonstrates that effective staff training in hygiene and limited, targeted precautions can effectively limit MRSA spread in nursing homes.
- Highlights the importance of adaptive infection control strategies in long-term care facilities.