Epidemic Bullous Impetigo in a Nursery Due to a Nasal Carrier of Staphylococcus aureus: Role of Epidemiology and Control Measures

1984 ◽  
Vol 5 (7) ◽  
pp. 326-331 ◽  
Author(s):  
Allyn K. Nakashima ◽  
James R. Allen ◽  
William J. Martone ◽  
Brian D. Plikaytis ◽  
Beth Storer ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Phage Type ◽  
Skin Lesions ◽  
Control Measures ◽  
Epidemic Strain ◽  
Nasal Carrier ◽  
Infection Control Measures ◽  
Epidemic Period ◽  
And Control

AbstractFrom September 14, 1981 to February 28, 1982, an epidemic of bullous impetigo caused by a penicillin/tetracycline resistant strain of Staphylococcus aureus, phage type 3A/3C, occurred in a newborn nursery in Louisville, Kentucky. Twenty of 1,181 (1.7%) infants at risk developed disease during the six-month epidemic period. Clinically all case-infants had bullous impetigo skin lesions. One infant developed staphylococcal septicemia. No infant died. An epidemiologic investigation identified a nurse as having significantly greater contact with case-infants than control-infants (p=0.0013). She was also found to be a nasal carrier of the epidemic strain. Infection control measures appeared to decrease infant-to-infant transmission via the hands of non-colonized nurses, but did not affect transmission from the nurse carrying the epidemic strain to infants. No cases of bullous impetigo have occurred since this nurse was temporarily removed from the nursery for treatment.

Outbreak of Staphylococcal Infection in Two Hospital Nurseries Traced to a Single Nasal Carrier

1986 ◽  
Vol 7 (10) ◽  
pp. 487-490 ◽  
Author(s):  
Anusha Belani ◽  
Robert J. Sherertz ◽  
Marsha L. Sullivan ◽  
Beverly A. Russell ◽  
Peter D. Reumen
Keyword(s):  
Staphylococcus Aureus ◽  
Community Hospital ◽  
Phage Type ◽  
Carrier State ◽  
Staphylococcal Infection ◽  
Skin Infections ◽  
Epidemic Strain ◽  
Upper Respiratory Tract ◽  
Nasal Carrier ◽  
Upper Respiratory

AbstractIn late January and early February 1983, an outbreak of skin infections (7 of 145 infants) caused by a penicillin/erythromycin resistant strain of Staphylococcus aureus (SA), phage type 3A/3C, occurred in our newborn nursery. A week following the first cluster of infections, another nursery outbreak due to SA with the same antibiogram occurred in a nearby community hospital (11 of 114 infants). Subsequently, a second cluster of infections with the same SA was identified at our nursery. The epidemic strain was carried in the anterior nares of a single nurse who worked at both hospital nurseries on alternate weeks. Investigation revealed that the nurse had an upper respiratory tract infection during each of these outbreaks—simulating “a cloud baby.” No further infections have occurred since this nurse was treated and her SA nasal carrier state eliminated.

scholarly journals Outbreak of clonal complex 22 Panton–Valentine leucocidin-positive methicillin-resistant Staphylococcus aureus

2017 ◽  
Vol 18 (5) ◽  
pp. 224-230 ◽  
Author(s):  
Mark I. Garvey ◽  
Craig W. Bradley ◽  
Kerry L. Holden ◽  
Beryl Oppenheim
Keyword(s):  
Staphylococcus Aureus ◽  
Infection Control ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Clinical Specimen ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
Spa Typing ◽  
Methicillin Resistant ◽  
Infection Control Measures ◽  
And Control

Aims: We describe the investigation and control of a nosocomial outbreak of Sequence Type (ST) 22 MRSA containing the Panton–Valentine leucocidin (PVL) toxin in an acute multispecialty surgical ward at University Hospital Birmingham NHS Foundation Trust. Methods: A patient was classed as acquiring methicillin-resistant Staphylococcus aureus (MRSA) if they had a negative admission screen and then had MRSA isolated from a subsequent screen or clinical specimen. Spa typing and pulsed field gel electrophoresis (PFGE) was undertaken to confirm MRSA acquisitions. Findings: The Infection Prevention and Control Team were alerted to the possibility of an outbreak when two patients acquired MRSA while being on the same ward. In total, five patients were involved in the outbreak where four patients acquired the PVL-MRSA clone from an index patient due to inadequate infection control practice. Two patients who acquired the strain developed a bloodstream infection. Infection control measures included decolonisation of affected patients, screening of all patients on the ward, environmental sampling and enhanced cleaning. Discussion: Our study highlights the potential risk of spread and pathogenicity of this clone in the healthcare setting. Spa typing and PFGE assisted with confirmation of the outbreak and implementation of infection control measures. In outbreaks, microbiological typing should be undertaken as a matter of course as without specialist typing identification of the described outbreak would have been delayed.

scholarly journals Tourism Impacts, Tourism-Phobia and Gentrification in Historic Centers: The Cases of Málaga (Spain) and Gdansk (Poland)

2021 ◽  
Vol 13 (1) ◽  
pp. 408
Author(s):  
Fernando Almeida-García ◽  
Rafael Cortés-Macías ◽  
Krzysztof Parzych
Keyword(s):  
Comparative Research ◽  
Control Measures ◽  
Tourism Impacts ◽  
Tourist Destinations ◽  
Tourist Flows ◽  
Tourist Accommodation ◽  
And Control ◽  
The Impact ◽  
Urban Characteristics

This study analyzes the role of residents in urban tourist destinations affected by the increase in tourist flows, which have generated various problems such as tourism, gentrification and the emergence of tourism as a threat to residents. The role of residents in tourist destinations has not been analyzed regularly during the development process of destinations. We study two cases of historic centers in European cities, with the aim of comparing tourism problems, which are common to most European urban destinations. This study was conducted by administering surveys amongst residents of these historic centers (378 in Málaga, Spain, and 380 in Gdansk, Poland). These cities show a similar demographic size and urban characteristics. This is the first comparative research on tourism-phobia and gentrification in destinations, a field of analysis that is still not studied much. We develop specific scales to measure gentrification and tourism-phobia; moreover, we study the impact of some tourist problems that affect residents (noise, dirt, occupation of public spaces, etc.), and we show the spatial distribution of tourism-phobia. The same analysis instruments are used for both cities. The results of this study show that the tourism-phobia situation is different in the analyzed destinations. It is more intense in the case of Málaga than in Gdansk. The two historic centers are especially affected by the processes of increased tourist flows and the growth of new forms of tourist accommodation. The research results show that the residents’ annoyance caused by tourism gentrification is more intense than tourism-phobia. Both case studies highlight the residents’ complaints regarding the inadequate management of problems by public stakeholders and control measures.

scholarly journals 855. Significance of Invasive Infections due to Methicillin Sensitive Staphylococcus aureus in the neonatal population

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S468-S468
Author(s):  
Mariawy Riollano ◽  
Deena Altman ◽  
shanna kowalsky ◽  
Stephanie Pan
Keyword(s):  
Staphylococcus Aureus ◽  
Clinical Characteristics ◽  
Invasive Disease ◽  
Control Measures ◽  
Invasive Infection ◽  
Single Center ◽  
Infection Control Measures ◽  
Invasive Infections ◽  
Mrsa Colonization ◽  
Neonatal Population

Abstract Background Staphylococcus aureus is a well-known cause of hospital acquired infections. Methicillin resistant staphylococcus aureus (MRSA) colonization is a recognized risk factor for invasive infections. The neonatal population in the intensive care unit (NICU) is particularly vulnerable to these types of infections, resulting in high mortality and morbidity. However, only scant data is available to establish the risk for invasive disease in patients with Methicillin sensitive staphylococcus aureus (MSSA). As a result, surveillance and prevention strategies are only address for MRSA colonization. Here, we describe the clinical characteristics of S. aureus colonized patients identified in late 2018 during transmission events in a single center NICU. As a result of the targeted surveillance investigation for MRSA infection control measures, S. aureus colonization was stratified, and we were able to compare the differences in invasive disease between MRSA and MSSA. Methods This is a retrospective chart review of the 47 colonized patients identified during October 2018- January 2019 SA transmission events in single center NICU. Risk factors, clinical characteristics, and the hospital course of these cases, including the proportion of invasive illness were reviewed. Results We found that most clinical characteristic, risk factors, and hospital course were the same between MRSA and MSSA colonized infants (p values > 0.05). Additionally, there was no difference in the proportion of invasive infection between MRSA and MSSA colonized patients (p value > 0.05). The type of invasive infections identified were SSTI, bacteremia, and osteomyelitis. Conclusion The proportion of invasive infection was the same in MSSA and MRSA colonized patients. This data provides us with supportive material for future recommendations of infection control measures for MSSA colonized patients. Disclosures All Authors: No reported disclosures

scholarly journals Leishmaniasis: Current Status of Vaccine Development

2001 ◽  
Vol 14 (2) ◽  
pp. 229-243 ◽  
Author(s):  
Emanuela Handman
Keyword(s):  
Dna Sequences ◽  
Vaccine Development ◽  
Development Program ◽  
Skin Lesions ◽  
Mononuclear Phagocytes ◽  
Control Measures ◽  
Host Susceptibility ◽  
Current Status ◽  
Dna Encoding ◽  
And Control

SUMMARY Leishmaniae are obligatory intracellular protozoa in mononuclear phagocytes. They cause a spectrum of diseases, ranging in severity from spontaneously healing skin lesions to fatal visceral disease. Worldwide, there are 2 million new cases each year and 1/10 of the world's population is at risk of infection. To date, there are no vaccines against leishmaniasis and control measures rely on chemotherapy to alleviate disease and on vector control to reduce transmission. However, a major vaccine development program aimed initially at cutaneous leishmaniasis is under way. Studies in animal models and humans are evaluating the potential of genetically modified live attenuated vaccines, as well as a variety of recombinant antigens or the DNA encoding them. The program also focuses on new adjuvants, including cytokines, and delivery systems to target the T helper type 1 immune responses required for the elimination of this intracellular organism. The availability, in the near future, of the DNA sequences of the human and Leishmania genomes will extend the vaccine program. New vaccine candidates such as parasite virulence factors will be identified. Host susceptibility genes will be mapped to allow the vaccine to be targeted to the population most in need of protection.

The Analysis of the Impact of a Mild, Low-iodine, Lotion Soap on the Reduction of Nosocomial Methicillin-Resistant Staphylococcus aureus: A New Opportunity for Surveillance by Objectives

1987 ◽  
Vol 8 (7) ◽  
pp. 284-288 ◽  
Author(s):  
Kim M. Onesko ◽  
Eugene C. Wienke
Keyword(s):  
Staphylococcus Aureus ◽  
Nosocomial Infections ◽  
Control Measures ◽  
Methicillin Resistant ◽  
Care Community ◽  
Infection Control Measures ◽  
Medical Division ◽  
Tract Infections ◽  
The Impact ◽  
Community Teaching

AbstractA significant unremitting increase in the incidence of nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infections in a 500-bed acute care community teaching hospital prompted reevaluation of the efficacy of the infection control measures used. A well-accepted, low-iodine, antimicrobial soap was used to replace a liquid natural handsoap in two areas with the highest incidence of MRSA—the intensive care unit, and a medical division.Over a two-year period, an analysis was made of the effect of soap replacement on nosocomial infections and pathogens. Soap changeover occurred at the midpoint of the two-year period. From year to year, the nosocomial MRSA rate decreased 80% (t test, P=0.005). Other pathogens that demonstrated a dramatic decrease included methicillin-sensitive Staphylococcus aureus (MSSA), infections where no pathogens were isolated, and various gram-negative infections. Categories of nosocomial infections that decreased included surgical wound infections, primary bacteremias, and respiratory tract infections. The overall nosocomial infection rate of the two combined areas decreased 21.5%, representing a year-to-year savings of $109,500. As a result, the decision was made to install the low-iodine hand-soap permanently at all sinks within the hospital.

scholarly journals Carriage ofStaphylococcus aureusamong 104 healthy persons during a 19-month period

1995 ◽  
Vol 115 (1) ◽  
pp. 51-60 ◽  
Author(s):  
N. H.Riewerts Eriksen ◽  
F. Espersen ◽  
V.Thamdrup Rosdahl ◽  
K. Jensen
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Susceptibility ◽  
Statistical Difference ◽  
Phage Type ◽  
Hospitalized Patients ◽  
Index Number ◽  
Carrier Rate ◽  
Type Distribution ◽  
Nasal Carrier ◽  
Healthy Persons

SummaryThe present study was undertaken to investigate the frequency of the nasal carrier rate ofStaphylococcus aureus. The investigation was performed on 104 healthy persons. The total number of swabs performed was 1498 and this resulted in isolation of 522S. aureusstrains. All strains have been identified, tested for antibiotic susceptibility, and phage-typed. The carrier-index (number of positive swabs/number of total swabs for each individual person) was compared with different sampling and culturing methods, phage type, age, and resistance to antibiotics. There was statistical difference in carrier rate according to sex (P·05). Among the 104 persons 15 (14·4%) were persistent carriers, 17 (16·3%) intermittent carriers, 55 (52·9%) occasional carriers and 17 (16·3%) non-carriers. Among intermittent and occasional carriers the phage-type distribution was different from theS. aureusstrains isolated from Danish hospitalized patients in 1992, while the persistent carriers had similar phage-type distribution.

Molecular Characterization ofStenotrophomonas maltophiliaIsolates from Cystic Fibrosis Patients and the Hospital Environment

2009 ◽  
Vol 30 (8) ◽  
pp. 753-758 ◽  
Author(s):  
Carolina Marzuillo ◽  
Maria De Giusti ◽  
Daniela Tufi ◽  
Alessandra Giordano ◽  
Angela Del Cimmuto ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Monitoring Program ◽  
Control Measures ◽  
Hospital Environment ◽  
Molecular Heterogeneity ◽  
Infection Control Measures ◽  
Clonal Spread ◽  
Multiple Strains ◽  
Outpatient Settings ◽  
And Control

Objectives.To ascertain whether cystic fibrosis (CF) patients are colonized or infected with unique or multiple strains ofStenotrophomonas maltophilia; to understand whether some strains colonize or infect more than 1 patient, indicating clonal spread; and to explore the molecular heterogeneity of hospital water isolates and their correlation with clinical isolates.Setting.The regional CF center of Policlinico “Umberto I” of Rome, Italy.Methods.The study was carried out on a random sample ofS. maltophiliaisolates (n= 110) collected from CF patients (n= 50) during the period 2002–2005 and on 24 water isolates obtained during a monitoring program in the first 6 months of 2005. Home environmental samplings were not performed. All isolates, which were recovered from cultures of specimens obtained in both inpatient and outpatient settings, were genotyped with DNA macrorestriction analysis with the restriction enzymeXbaland pulsed-field gel electrophoresis.Results.One-third of the patients with repeated episodes ofS. maltophiliainfection or colonization hosted more than 1 strain. A potential transmission, defined as the isolation of the same strain in 2 or more patients, occurred 5 times, showing a frequency of potential transmission episodes slightly higher than previously reported. Water, taps, and sinks of the different rooms of the CF center tended to be persistently colonized with the same strain ofS. maltophilia, with no correlation between clinical and water-associated isolates.Conclusions.The study does not provide sufficient data to conclude definitively that isolation of colonized or infected CF patients and control of hospital water systems contamination would be beneficial infection control measures. Epidemiologic analytical studies that correlate the presence ofS. maltophiliawith clinical outcomes are strongly needed.

scholarly journals Automatic Alerts for Methicillin-Resistant Staphylococcus aureus Surveillance and Control: Role of a Hospital Information System

1996 ◽  
Vol 17 (8) ◽  
pp. 496-502 ◽  
Author(s):  
Didier Pittet ◽  
Edith Safran ◽  
Stephan Harbarth ◽  
François Borst ◽  
Pascale Copin ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Information System ◽  
Infection Control ◽  
Hospital Information System ◽  
Hospital Admissions ◽  
Control Measures ◽  
Clinical Microbiology Laboratory ◽  
Infection Control Program ◽  
Methicillin Resistant

AbstractBackground: Methicillin-resistant Staphylococcus aureus (MRSA) is an escalating problem in hospitals worldwide. The hospital reservoir for MRSA includes recognized and unrecognized colonized or infected patients, as well as previously colonized or infected patients readmitted to the hospital. Early and appropriate infection control measures (ICM) are key elements to reduce MRSA transmission and to control the hospital reservoir.Objective: To describe the role of an expert system applied to the control of MRSA at a large medical center (1,600 beds) with high endemic rates.Methods: The University Hospital of Geneva has an extended hospital information system (HIS), DIOGENE, structured with an open distributed architecture. It includes administrative, medical, nursing, and laboratory applications with their relational databases. Among available patient databases, clinical microbiology laboratory and admission-discharge-transfer (ADT) databases are used to generate computer alerts. A laboratory alert (lab alert) is printed daily in the Infection Control Program (ICP) offices, listing all patients with cultures positive for MRSA detected within the preceding 24 hours. Patients might be either newly detected patients colonized or infected with MRSA, or previously recognized MRSA patients having surveillance cultures. The ICP nurses subsequently go to the ward or call the ward personnel to implement ICM. A second alert, the “readmission alert,” detects readmission to the hospital of any patient previously colonized or infected with MRSA by periodic queries (q 1 min) to the ADT database. The readmission alert is printed in the ICP offices, but also forwarded with added guidelines to the emergency room.Results: During the first 12 months of application (July 1994 to June 1995), the lab alert detected an average of 4.6 isolates per day, corresponding to 314 hospital admissions (248 patients); the use of this alert saved time for the ICP nurses by improving work organization. There were 438 readmission alerts (1.2 alerts per day) over the study period; of 347 patients screened immediately upon readmission, 114 (33%) were positive for MRSA carriage. Delayed recognition of readmitted MRSA carriers decreased significantly after the implementation of this alert; the proportion of MRSA patients recognized at the time of admission to the hospital increased from 13% in 1993 to 40% in 1995 (P<.001).Conclusions: Hospital information system-based alerts can play an important role in the surveillance and early prevention of MRSA transmission, and it can help to recognize patterns of colonization and transmission.

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