Carré N, Herbreteau N, Askeur N, Dabas J-P, Sillam F, Pinchon C, Bes M, Tristan A, Vandenesch F
Cellule de l'InVS en région Île-de-France, 58-62 rue de Mouzaïa, Paris cedex 19, France.
Med Mal Infect. 2011 Jul;41(7):364-71. doi: 10.1016/j.medmal.2010.12.017. Epub 2011 Mar 31.
The study objectives were to describe an outbreak of skin infections in school settings, caused by Staphylococcus aureus carrying Panton-Valentine leukocidin genes (Sa PVL(+)), over a 2-year period. Nasal colonization prevalence was assessed in families where new skin infections occurred, despite a prevention and control strategy.
A retrospective investigation of skin infections likely to be related to Sa and prospective monitoring and treatment of new infections occurring in pupils and their family members were implemented in October 2006, following the reporting of Sa PVL(+) abscesses and furuncles in a primary school. Additional nasal screening was performed in families where new skin infections occurred, after an initial systematic screening of Sa PVL(+) nasal carriers.
On October 31, 2008, 53 patients, accounting for 30 households, had developed 69 skin infections, in four decreasing outbreaks. The cumulative incidence of a first skin infection was 34.6% in primary classes, 21.3% in nursery schools, and 6.5% in the pupils' family households. Several skin infections were reported in 13 households, and in one of them, all of the seven family members had developed at least one skin infection during follow-up. The estimated frequency of nasal colonization ranged from 14.1% to 19.5% according to successive nasal screenings.
Early reporting of skin infection clusters is necessary to reinforce the effectiveness of hygiene and prevention measures, and thus limit the risk of a long-lasting outbreak.
本研究旨在描述在两年时间里，由携带潘顿-瓦伦丁杀白细胞素基因（Sa PVL(+)）的金黄色葡萄球菌引起的学校环境中的皮肤感染暴发情况。尽管采取了预防和控制策略，但仍对新发生皮肤感染的家庭进行了鼻腔定植患病率评估。
2006年10月，在一所小学报告了Sa PVL(+)脓肿和疖肿后，对可能与Sa相关的皮肤感染进行了回顾性调查，并对学生及其家庭成员中新发生的感染进行了前瞻性监测和治疗。在对Sa PVL(+)鼻腔携带者进行初始系统筛查后，对新发生皮肤感染的家庭进行了额外的鼻腔筛查。
到2008年10月31日，53名患者（来自30户家庭）发生了69例皮肤感染，共出现4次规模逐渐减小的暴发。小学班级中首次皮肤感染的累积发病率为34.6%，幼儿园为21.3%，学生家庭为6.5%。13户家庭报告了多例皮肤感染，其中一户家庭的7名家庭成员在随访期间均至少发生了1次皮肤感染。根据连续的鼻腔筛查，估计鼻腔定植频率在14.1%至19.5%之间。
早期报告皮肤感染聚集情况对于加强卫生和预防措施的有效性、从而限制长期暴发的风险是必要的。
