Alsubaie Sarah, Bahkali Khawater, Somily Ali M, Alzamil Fahad, Alrabiaah Abdulkareem, Alaska Abdulkareem, Alkhattaf Fatmah, Kambal Abdelmageed, Al-Qahtani Ahmed A, Al-Ahdal Mohammed N
Departments of Pediatrics, College of Medicine, King Saud University and King Khalid University Hospital, Riyadh, Saudi Arabia.
Pediatr Int. 2012 Dec;54(6):786-92. doi: 10.1111/j.1442-200X.2012.03673.x. Epub 2012 Sep 11.
Infection due to community-acquired strains of methicillin-resistant Staphylococcus aureus (CA-MRSA) has been reported with increasing frequency. Herein is described the nosocomial transmission of CA-MRSA involving 13 neonates and two mothers in a well-infant nursery in a teaching hospital in Saudi Arabia.
From October to November 2009, temporally related cases of CA-MRSA skin and soft-tissue infection occurred in newborns shortly after discharge from a well-infant nursery. An outbreak investigation including case identification, review of medical records, staff screening, environmental cultures, pulsed-field gel electrophoresis, and a case-control study were conducted. Controls were selected from among asymptomatic neonates admitted to the same nursery and matched for the day of admission.
Fifteen subjects were found to be CA-MRSA positive: 13 neonates and two mothers. The crude attack rate among neonates was 5.5% during the outbreak period. All 13 neonates presented with skin and soft-tissue infection; one of the mothers had mastitis and a breast abscess. The source of the outbreak was not evident. Pulsed-field gel electrophoresis showed that all of the tested isolates from one strain except one, all contained the staphylococcal cassette chromosome mec (SCCmec) type IV.
MRSA strains that initially emerged in the community are now causing disease in health-care settings. Adherence to standard infection control practices, including consistent hand hygiene, in newborn nurseries is important to prevent transmission in such settings.
社区获得性耐甲氧西林金黄色葡萄球菌（CA-MRSA）感染的报道日益增多。本文描述了沙特阿拉伯一家教学医院母婴健康护理室中13例新生儿和2名母亲发生的CA-MRSA医院内传播情况。
2009年10月至11月，母婴健康护理室的新生儿出院后不久，出现了与时间相关的CA-MRSA皮肤和软组织感染病例。开展了一次暴发调查，包括病例识别、病历审查、工作人员筛查、环境培养、脉冲场凝胶电泳以及一项病例对照研究。对照从入住同一护理室的无症状新生儿中选取，并按入院日期进行匹配。
发现15名受试者CA-MRSA呈阳性：13例新生儿和2名母亲。暴发期间新生儿的粗发病率为5.5%。所有13例新生儿均出现皮肤和软组织感染；其中一名母亲患有乳腺炎和乳腺脓肿。暴发源不明。脉冲场凝胶电泳显示，除一株外，所有测试菌株均含有葡萄球菌盒式染色体mec（SCCmec）IV型。
最初在社区出现的MRSA菌株现正在医疗机构中引发疾病。在新生儿护理室坚持标准的感染控制措施，包括持续手部卫生，对于预防此类环境中的传播很重要。
