Outbreak of Methicillin‐resistant Staphylococcus aureus in a Hospital Center for Children's and Women's Health in a Swedish County

Abstract

The objective of this study was to investigate a sudden increase in methicillin-resistant Staphylococcus aureus (MRSA) cases primarily in one maternity ward at the Center for Children's and Women's Health at Link€ oping University Hospital, Sweden. Approximately 300 individuals including patients, their family members, and healthcare workers were screened for MRSA. The antibiotic susceptibility was tested and isolates polymerase chain reaction (PCR)-positive for the mecA gene were spa typed. Isolates with the same antibiogram and spa type were further whole genome sequenced. Compliance to current cleaning and hygiene routines was also controlled, and environmental samples collected. The results showed that a total of 13 individuals were involved in the outbreak. It was caused by a t386 MRSA strain (ST-1, NCBI-accession AB505628) with additional resistance to erythromycin and clindamycin. All cases were epidemiologically connected to the index patient, who had recently emigrated from a high-endemic area for MRSA. With improved cleaning and better compliance to basic hygiene routines, no further cases were reported. This study demonstrates how rapid an MRSA strain can disseminate in a ward with susceptible patients and insufficient cleaning and hygiene. For a better control of MRSA, clinical cultures and screening samples need to be obtained early and more extensively than according to the current recommendations.

Insights from a decade of surveillance: Molecular epidemiology of methicillin-resistant Staphylococcus aureus in Norway from 2008 to 2017

“…Furthermore, it is concerning that these MRSA spa -types have been reported to cause relatively large neonatal outbreaks, in Norway (unpublished data) and in Denmark [ 27 , 30 ]. MRSA t127, along with MRSA t688, was significantly associated with neonates and infants (< 1 year) in this study, the latter also to outbreaks, and has previously been found in maternity wards in Sweden [ 31 ], Ireland [ 32 ] and Kuwait [ 33 ].…”

Multi-resistant Bacteria to Antibiotics in Hospitals: The Case of Neonatology Services of the University Hospitals Centers of Abidjan, Côte d'Ivoire

“…The most recent data for 85 WHO member countries reported rates exceeding 20% in all regions and even 80% in some countries [28]. MRSA has caused several hospital outbreaks in neonatal care units [29][30][31]. Reports from various studies have discussed the important risk factor of colonized caregivers in the occurrence of these outbreaks [32][33].…”

Risk factors for methicillin-resistant Staphylococcus aureus colonization in a level-IV neonatal intensive care unit: a retrospective study

“…5 Although both MSSA and MRSA have been shown to cause outbreaks in NICUs, the focus has mainly been on MRSA outbreaks reported in various NICUs, with several risk factors investigated. 1,2,[6][7][8][9][10][11][12][13] Methicillin-resistant S. aureus may be transmitted directly from asymptomatic carriers (eg parents and health care professionals (HCPs)) or indirectly by contact with contaminated objects or environmental surfaces, where it can survive on dry surfaces for months. [14][15][16] Close contact between admitted neonates and HCPs, parents, and the environment facilitates bacterial flora exchange and colonization, with a subsequent risk of infection.…”