Department of Epidemiology, National Institute of Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
Antimicrob Resist Infect Control. 2012 Nov 20;1(1):37. doi: 10.1186/2047-2994-1-37.
We describe an outbreak of Bullous Impetigo (BI), caused by a (methicillin susceptible, fusidic acid resistant) Staphylococcus aureus (SA) strain, spa-type t408, at the neonatal and gynaecology ward of the Jeroen Bosch hospital in the Netherlands, from March-November 2011.
We performed an outbreak investigation with revision of the hygienic protocols, MSSA colonization surveillance and environmental sampling for MSSA including detailed typing of SA isolates. Spa typing was performed to discriminate between the SA isolates. In addition, Raman-typing was performed on all t408 isolates.
Nineteen cases of BI were confirmed by SA positive cultures. A cluster of nine neonates and three health care workers (HCW) with SA t408 was detected. These strains were MecA-, PVL-, Exfoliative Toxin (ET)A-, ETB+, ETAD-, fusidic acid-resistant and methicillin susceptible. Eight out of nine neonates and two out of three HCW t408 strains yielded a similar Raman type. Positive t408 HCW were treated and infection control procedures were reinforced. These measures stopped the outbreak.
We conclude that treatment of patients and HCW carrying a predominant SA t408, and re-implementing and emphasising hygienic measures were effective to control the outbreak of SA t408 among neonates.
我们描述了 2011 年 3 月至 11 月期间，荷兰杰罗恩博施医院新生儿和妇科病房爆发的由（甲氧西林敏感、夫西地酸耐药）金黄色葡萄球菌（SA）株 t408 引起的脓疱疮（BI）。
我们进行了暴发调查，修订了卫生协议，对 MSSA 定植进行了监测，并对 MSSA 进行了环境采样，包括对 SA 分离株进行详细的分型。spa 分型用于区分 SA 分离株。此外，对所有 t408 分离株进行了拉曼分型。
19 例 BI 通过 SA 阳性培养得到确认。检测到一组 9 例新生儿和 3 例卫生保健工作者（HCW）与 SA t408 有关。这些菌株均为 mecA-、PVL-、表皮剥脱毒素（ET）A-、ETB+、ETAD-、夫西地酸耐药和甲氧西林敏感。9 例新生儿中的 8 例和 3 例 HCW t408 株产生了类似的拉曼类型。对携带 t408 的 HCW 进行了治疗，并加强了感染控制程序。这些措施阻止了疫情的爆发。
我们得出结论，对携带优势 SA t408 的患者和 HCW 进行治疗，以及重新实施和强调卫生措施，是控制新生儿中 SA t408 爆发的有效措施。
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