Lamanna Onofrio, Bongiorno Dafne, Bertoncello Lisa, Grandesso Stefano, Mazzucato Sandra, Pozzan Giovanni Battista, Cutrone Mario, Chirico Michela, Baesso Flavia, Brugnaro Pierluigi, Cafiso Viviana, Stefani Stefania, Campanile Floriana
Ospedale dell'Angelo, Mestre, Venice, Italy.
MMARLab - Department of Biomedical and Biotechnological Sciences (BIOMETEC), University of Catania, Via Santa Sofia 97, 95123, Catania, Italy.
Ital J Pediatr. 2017 Jan 6;43(1):5. doi: 10.1186/s13052-016-0323-y.
The aims of this study were to identify the source and the transmission pathway for a Staphylococcal Scalded Skin Syndrome (SSSS) outbreak in a maternity setting in Italy over 2 months, during 2014; to implement appropriate control measures in order to prevent the epidemic spread within the maternity ward; and to identify the Methicillin-Resistant Staphylococcus aureus (MRSA) epidemic clone.
Epidemiological and microbiological investigations, based on phenotyping and genotyping methods, were performed. All neonates involved in the outbreak underwent clinical and microbiological investigations to detect the cause of illness. Parents and healthcare workers were screened for Staphylococcus aureus to identify asymptomatic carriers.
The SSSS outbreak was due to the cross-transmission of a rare clone of ST5-CA-MRSA-SCCmecV-spa type t311, exfoliative toxin A-producer, isolated from three neonates, one mother (from her nose and from dermatological lesions due to pre-existing hand eczema) and from a nurse (colonized in her nose by this microorganism). The epidemiological and microbiological investigation confirmed these as two potential carriers.
A rapid containment of these infections was obtained only after implementation of robust swabbing of mothers and healthcare workers. The use of molecular methodologies for typing was able to identify all carriers and to trace the transmission.
本研究的目的是确定2014年意大利一家产科机构在两个月内发生的葡萄球菌烫伤样皮肤综合征（SSSS）暴发的源头和传播途径；实施适当的控制措施以防止疫情在产科病房内蔓延；并识别耐甲氧西林金黄色葡萄球菌（MRSA）流行克隆株。
基于表型和基因分型方法进行了流行病学和微生物学调查。对所有参与暴发的新生儿进行了临床和微生物学调查以检测病因。对父母和医护人员进行了金黄色葡萄球菌筛查以识别无症状携带者。
SSSS暴发是由于一种罕见的ST5-CA-MRSA-SCCmecV-spa t311型克隆株的交叉传播，该克隆株产剥脱毒素A，从三名新生儿、一名母亲（从其鼻腔以及因原有手部湿疹引起的皮肤病变处）和一名护士（鼻腔被该微生物定植）中分离得到。流行病学和微生物学调查证实这两人为潜在携带者。
仅在对母亲和医护人员进行强力拭子采样后，才迅速控制了这些感染。使用分子分型方法能够识别所有携带者并追踪传播情况。
