Institute for Medical Microbiology and Hospital Epidemiology, Hannover Medical School, Hannover, Germany.
Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Burn Center, Hannover Medical School, Hannover, Germany.
J Hosp Infect. 2018 Feb;98(2):127-133. doi: 10.1016/j.jhin.2017.07.023. Epub 2017 Jul 26.
Meticillin-resistant Staphylococcus aureus (MRSA) is a frequently encountered pathogen in burn units. Burn patients are especially susceptible to MRSA acquisition and MRSA spread may cause outbreaks in burn units.
To report the characteristics and successful control of an MRSA outbreak and to demonstrate a multimodal infection control concept.
In addition to a pre-existing infection control concept, several control measures were implemented including weekly prevalence screenings for MRSA, reinforcement of disinfection, restriction of admissions, and short-term unit closure. Epidemiologic investigation and environmental examinations were performed. The outbreak isolates were analysed by pulsed-field gel electrophoresis and spa-typing. A PubMed search was conducted, focusing on MRSA outbreaks in burn units.
This outbreak of hospital-acquired MRSA affected eight patients during a seven-month period, yielding an attack rate of 8%. Epidemiologic and environmental examinations suggested patient-to-patient transmission, which was confirmed by molecular analysis of bacterial isolates revealing a monoclonal pattern. In accordance with findings from other outbreaks in burn units, the implemented measures including patient screening and temporary unit closure resulted in successful control of the outbreak.
A comprehensive concept is required to control the spread of all multidrug-resistant micro-organisms including MRSA on a burn unit. Where patients colonized or infected with MRSA appear to be the main reservoir, transfer of these patients to other units, or temporary closure of the unit, accompanied by intensive cleaning are very effective measures to stop transmission events.
耐甲氧西林金黄色葡萄球菌（MRSA）是烧伤病房中常见的病原体。烧伤患者尤其容易感染 MRSA，MRSA 的传播可能导致烧伤病房爆发感染。
报告 1 次 MRSA 暴发的特征和成功控制情况，并展示多模式感染控制概念。
除了现有的感染控制概念外，还实施了几项控制措施，包括每周进行 MRSA 患病率筛查、加强消毒、限制入院和短期关闭病房。进行了流行病学调查和环境检查。对暴发分离株进行了脉冲场凝胶电泳和 spa 型分析。对PubMed 进行了检索，重点关注烧伤病房中的 MRSA 暴发。
此次医院获得性 MRSA 暴发影响了 8 名患者，在 7 个月内的发病率为 8%。流行病学和环境检查提示存在患者之间的传播，细菌分离株的分子分析证实了这一点，显示出单克隆模式。根据烧伤病房中其他暴发的结果，实施的措施包括患者筛查和临时病房关闭，成功控制了暴发。
需要采用全面的概念来控制烧伤病房中所有包括 MRSA 在内的多重耐药微生物的传播。如果患者定植或感染 MRSA 似乎是主要的传染源，将这些患者转移到其他病房，或暂时关闭病房，并进行强化清洁，是阻止传播事件的非常有效的措施。
