Molecular Studies of an Impetigo Bullosa Epidemic in Full-Term Infants

Abstract

Background: Carriers ofStaphylococcus aureus strains can be the source of epidemic infection for patients. Objectives: A molecular epidemiological analysis of an impetigo bullosa outbreak in a neonatal ward was performed in order to determine a potential source of the infection and possible routes of subsequent spreading of the epidemic strain. Methods: The genetic relatedness of S. aureus strains isolated from 6 neonates with epidermal lesions and from 21 staff members was verified by the pulsed field gel electrophoresis (PFGE) method. Additionally, detection of eta and etb genes of S. aureus strains using PCR was performed. Results: None of the infected newborns’ mothers was a carrier. Seven strains, 6 isolated from the newborns and 1 taken from a midwife, showed the same restriction pattern, i.e. type A. In the other 20 health care workers colonized with S. aureus, 3 genetic types could be distinguished, i.e. B (2), C (7) and D (2), as well as 9 strains with unique PFGE patterns. The eta gene detected in 7 strains belonged to the genetic type A; there was no etb gene in any of the 27 S. aureus isolates. Conclusions: The presence of the same genetic type A of S. aureus in the infected newborns is a factor which indicates that the impetigo bullosa was a hospital infection. A probable source of the infection was a midwife who was colonized with the same S. aureus type. She was present at the birth of the first infected newborn. Today, molecular methods are essential for prompt recognition of an epidemic and implementation of appropriate infection control strategies.

Use of Skin Substitute Dressings in the Treatment of Staphylococcal Scalded Skin Syndrome in Neonates and Young Infants

“…The Tzanck smear is also an easy method to illustrate acantholysis [16] . Determining the exfoliative toxin produced by the S. aureus can be helpful in epidemiological studies during outbreaks on neonatal wards but is not necessary for the diagnosis SSSS [17] . To prevent out- Seven cases with SSSS.…”

“…Case 5 published before [11]. [17] . Recently, Blyth et al [3] described the diagnosis and treatment in 4 older children with SSSS.…”

Passive acquisition of anti-Staphylococcus aureus antibodies by newborns via transplacental transfer and breastfeeding, regardless of maternal colonization

“…In the neonatal period, S. aureus has been associated with a variety of disorders of varying degrees of severity, such as nosocomial outbreaks of neonatal impetigo 1, omphalitis 2, arthritis and osteomyelitis 3, late neonatal nosocomial or community-acquired sepsis 4,5, and sudden infant death syndrome 6. A systematic review of the literature, with 19 studies and more than 4000 blood culture isolates identified that the most common causes of neonatal bacteremia were S taphylococcus aureus, Escherichia coli and Klebsiella spp.…”

Avaliação da transferência placentária e pelo colostro de anticorpos IgG e IgA anti-Staphylococcus aureus em mães com e sem colonização nasal

“…No período neonatal, o S. aureus tem sido associado às infecções de gravidade variável, como surtos nosocomiais de impetigo neonatal (JURSA-KULESZA et al, 2009), onfalite (MIR et al, 2011), artrite e osteomielite (BERBERIAN et al, 2010;MONTGOMERY et al, 2013), sepse neonatal tardia, adquirida em hospital ou oriunda da comunidade (GANATRA e ZAIDI, 2010;DOWNIE et al, 2013;COOMBS et al, 2013) e à síndrome da morte súbita infantil (HARRISON et al, 2008;WEBER et al, 2011).…”

“…Among the bacteria that colonize mucous membranes of pregnant women and, soon after birth, their newborns (NB), is Staphylococcus aureus (S. aureus). In the neonatal period, S. aureus has been associated with infections of variable severity, as nosocomial outbreaks of neonatal impetigo [1], omphalitis [2], arthritis and osteomyelitis [3], late neonatal sepsis nosocomial or community-acquired [4][5][6], and the sudden infant death syndrome [7,8].…”