Public Health England, East Midlands Public Health England Centre, Leicester, United Kingdom.
Euro Surveill. 2014 Aug 21;19(33):20880. doi: 10.2807/1560-7917.es2014.19.33.20880.
Staphylococcal scalded skin syndrome (SSSS) is a blistering skin condition caused by exfoliative toxin-producing strains of Staphylococcus aureus. Outbreaks of SSSS in maternity settings are rarely reported. We describe an outbreak of SSSS that occurred among neonates born at a maternity unit in England during December 2012 to March 2013. Detailed epidemiological and microbiological investigations were undertaken. Eight neonates were found to be infected with the outbreak strain of S. aureus, of spa type t346, representing a single pulsotype. All eight isolates contained genes encoding exfoliative toxin A (eta) and six of them contained genes encoding toxin B (etb). Nasal swabs taken during targeted staff screening yielded a staphylococcal carriage rate of 21% (17/80), but none contained the outbreak strain. Mass screening involving multi-site swabbing and pooled, enrichment culture identified a healthcare worker (HCW) with the outbreak strain. This HCW was known to have a chronic skin condition and their initial nasal screen was negative. The outbreak ended when they were excluded from work. This outbreak highlights the need for implementing robust swabbing and culture methodswhen conventional techniques are unsuccessful in identifying staff carrier(s). This study adds to the growing body of evidence on the role of HCWs in nosocomial transmission of S. aureus.
葡萄球菌性烫伤样皮肤综合征（SSSS）是一种由产表皮剥脱毒素的金黄色葡萄球菌引起的水疱性皮肤病。产妇环境中 SSSS 的爆发很少报道。我们描述了 2012 年 12 月至 2013 年 3 月在英格兰一家产科病房发生的新生儿 SSSS 爆发。进行了详细的流行病学和微生物学调查。发现 8 名新生儿感染了 t346 型 spa 的金黄色葡萄球菌爆发株，代表单一脉冲群。所有 8 个分离株均含有编码表皮剥脱毒素 A（eta）的基因，其中 6 个分离株含有编码毒素 B（etb）的基因。在有针对性的员工筛查中采集的鼻拭子显示金黄色葡萄球菌携带率为 21%（17/80），但均未发现爆发株。涉及多点拭子和混合、富集培养的大规模筛查确定了一名携带爆发株的医护人员（HCW）。该 HCW 已知患有慢性皮肤病，其最初的鼻拭子为阴性。当他们被排除在工作之外时，疫情结束了。此次疫情爆发凸显了在常规技术未能识别出员工携带者时，需要实施强有力的拭子和培养方法。本研究增加了越来越多的证据表明医护人员在医院获得性金黄色葡萄球菌传播中的作用。
