Nosocomial outbreak of staphylococcal scalded skin syndrome in neonates: epidemiological investigation and control

Helali, Najoua El; Carbonne, A.; Naas, Thierry; Kernéis, Solen; Fresco, O.; Giovangrandi, Yves; Fortineau, Nicolas; Nordmann, Patrice; Astagneau, Pascal

doi:10.1016/j.jhin.2005.02.013

Cited by 65 publications

(42 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Staphylococcus aureus is a human commensal as well as a cause of a wide range of infections (5,8,19). A significant fraction of the human population is colonized with S. aureus on epithelial surfaces, of which the anterior nares are the most frequent carriage sites (3,11,13,19,20).…”

mentioning

confidence: 99%

Dynamics and Determinants of Staphylococcus aureus Carriage in Infancy: the Generation R Study

et al. 2008

View full text Add to dashboard Cite

Serial nasal swabs were collected at the ages of 1.5, 6, and 14 months from 443 infants in the Generation R Study. The objective was to study the dynamics and determinants of Staphylococcus aureus nasal carriage in the first year of life. The prevalence of S. aureus carriage decreased in the first year of life, from 52.1% at the age of 1.5 months to 12.9% at 14 months. Persistent carriage, defined as continuous carriage of the same S. aureus strain at the three sampling moments, was rarely detected in early infancy.

show abstract

mentioning

confidence: 99%

Dynamics and Determinants of Staphylococcus aureus Carriage in Infancy: the Generation R Study

et al. 2008

View full text Add to dashboard Cite

show abstract

“…Included in the toxin group are also the exfoliative toxins A and B (Zecconi & Scali 2013), responsible for staphylococcal scaled skin syndrome (SSSS), which causes skin layers to separate and scale off. SSSS occurs primarily in infants and children and outbreaks have been reported from maternity units (El Helali et al 2005;O'Connell et al 2007). …”

Section: Toxinsmentioning

confidence: 99%

Infection control of Staphylococcus aureus : spa typing to elucidate transmission

Mernelius¹

2015

View full text Add to dashboard Cite

Staphylococcus aureus is a commensal of the human flora, primarily colonizing the anterior nares and throat, but it may also cause infections ranging from mild skin and soft tissue infections to severe diseases such as endocarditis and septicemia. S. aureus is also a major nosocomial problem increasing with the worldwide dissemination of methicillin-resistant S. aureus (MRSA).The main vector for bacterial cross-transmission in healthcare settings is the hands of healthcare workers (HCWs). No S. aureus was detected in the air in this thesis demonstrating that transmission through air is not important. Despite the fact that good compliance with hand hygiene is essential to prevent cross-transmission the compliance is generally less than 50 %.Gold standard to track bacterial transmission in healthcare settings has for long been pulsedfield gel electrophoresis (PFGE), a method that is labor-intensive, lacks consensus protocol and relies on semi-subjective analysis. Molecular typing by sequencing of the hypervariable part of the S. aureus protein A gene (spa typing) has overcome these problems and has shown promising results in epidemiological investigations.The aims of this thesis were to study bacterial transmission with S. aureus colonization of newborn infants as a model and to evaluate spa typing as a molecular tool. Additionally, the influence of compliance with hygiene guidelines on S. aureus transmission was assessed.Analysis of 280 MRSA isolates by spa typing revealed excellent typeability and epidemiological concordance and satisfactory discriminatory power. Additionally, spa typing was considered superior to PFGE thanks to its accessibility, ease of use and rapidity. Also, spa typing results are registered in a global database, facilitating inter-laboratory comparison.The prevalence of S. aureus ranged from 41 % to 66 % in the populations studied and males had the highest colonization rate. Throat was the premier colonization site for adults and transmission from individuals colonized in the throat only was documented, suggesting that throat cultures should be included in S. aureus screening programs. The umbilicus was the premier colonization site for newborn infants. Incubating the swabs in enrichment broth prior to plating increased the prevalence of S. aureus positive samples by 46 %, resulting in prevalence viii ranging from 51 % to 70 % in the populations studied. Thus enrichment prior to plating is necessary to determine more truthful S. aureus colonization rates. There were no indications of an institutional flora, as the colonization rates, spa type distribution and antibiotic resistance prevalence were similar among parents and HCWs.Direct observations and self-reporting by HCWs were both validated as tools for monitoring compliance with hygiene guidelines. The compliance with hygiene guidelines was significantly higher following a 10-point hygiene intervention as compared to baseline. The compliance was also higher three years after the intervention in three of four participating departm...

show abstract

“…The corresponding patients' clinical manifestations (SSSS and bullous impetigo in seven and three cases, respectively) were directly compatible with classical toxin activity (2,14,30,38).…”

Section: Discussionmentioning

confidence: 70%

Toxin Profiling of Staphylococcus aureus Strains Involved in Varicella Superinfection

et al. 2010

View full text Add to dashboard Cite

The most common complications of varicella are bacterial skin and soft tissue infections, generally due to Staphylococcus aureus and group A beta-hemolytic streptococci. The aim of this study was to characterize the toxin and antibiotic resistance profiles of S. aureus isolates involved in varicella complications. Between 2002 and 2007, the French Reference Centre for Staphylococci collected 58 S. aureus isolates involved in varicella superinfection. All the isolates were characterized by screening for 12 toxin genes, agr typing, and mecA gene detection; some isolates were also studied by spa typing, multilocus sequence typing (MLST), and resistance profiling. A major toxin gene was detected in 53% (31/58) of the isolates (genes for exfoliative toxins A and B, 17.2%; Panton-Valentine leukocidin gene, 8.6%; toxic shock syndrome toxin 1 gene, 27.6%). Most clinical manifestations were directly compatible with the classical activity of these toxins. Nineteen isolates (33%) were resistant to methicillin, and 12 of these isolates belonged to an emerging agr-2, ST5 clone that harbors the toxic shock syndrome toxin 1 gene. These data should be considered in the management and treatment of patients with varicella complicated by S. aureus superinfection. Antibiotics that decrease toxin production, such as clindamycin, may provide benefit, and their efficacy against bacterial superinfections in children with varicella should be studied.

show abstract

Nosocomial outbreak of staphylococcal scalded skin syndrome in neonates: epidemiological investigation and control

Cited by 65 publications

References 31 publications

Dynamics and Determinants of Staphylococcus aureus Carriage in Infancy: the Generation R Study

Dynamics and Determinants of Staphylococcus aureus Carriage in Infancy: the Generation R Study

Infection control of Staphylococcus aureus : spa typing to elucidate transmission

Toxin Profiling of Staphylococcus aureus Strains Involved in Varicella Superinfection

Contact Info

Product

Resources

About