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Spread of a Methicillin-Resistant Staphylococcus aureus ST80-IV Clone in a Danish Community

Published online by Cambridge University Press:  21 June 2016

Tinna Urth ,
Gitte Juul ,
Robert Skov  and
Henrik C. Schønheyder
Tinna Urth
Affiliation:
Department of Clinical Microbiology, Aalborg Hospital–Aarhus University Hospital, Aalborg, Denmark
Gitte Juul
Affiliation:
Department of Clinical Microbiology, Aalborg Hospital–Aarhus University Hospital, Aalborg, Denmark
Robert Skov
Affiliation:
National Center for Antimicrobials and Infection Control, Statens Serum Institut, Copenhagen, Denmark
Henrik C. Schønheyder*
Affiliation:
Department of Clinical Microbiology, Aalborg Hospital–Aarhus University Hospital, Aalborg, Denmark Department of Clinical Epidemiology, Aalborg Hospital–Aarhus University Hospital, Aalborg, Denmark
*
Department of Clinical Microbiology, Aalborg Hospital, P.O. Box 365, DK-9100 Aalborg, Denmark. [email protected]
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Abstract

Objective:

We report a community cluster of methicillin-resistant Staphylococcus aureus (MRSA) in Denmark with emphasis on routes of transmission and infection control measures. The objective is to extend knowledge of MRSA in a community setting where a nosocomial link could effectively be ruled out.

Design:

Population-based observational study from November 1997 until June 2003.

Setting:

North Jutland County, with approximately 495,000 inhabitants.

Subjects:

The cluster encompassed 46 individuals and 26 households.

Interventions:

Infection control measures included repeated visits to affected households by an infection control nurse who undertook screening for carriage among all household members and provided a program for decolonization.

Results:

The causal strain was identical to a newly described international clone, ST80; SSCmec type IV; and Panton–Valentine leukocidin positive. Plausible routes of transmission included household contact and contact at work, kindergarten, and school. We did not detect a nosocomial source or any secondary cases in hospitals. Transmission by healthcare contact outside the hospital was plausible for three cases. We found evidence that the clone was introduced on more than one occasion to immigrant families from the Middle East. A 5-day decolonization program was successful at first attempt in 15 of 16 households that could be evaluated.

Conclusions:

Despite the described infection control measures, we continued to see new cases, underlining a need for a national policy to contain MRSA in the community.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 26 , Issue 2 , February 2005 , pp. 144 - 149
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2005

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References

1.Salgado, CD, Farr, BM, Calfee, DP. Community-acquired methicillin-resistant Staphylococcus aureus: a meta-analysis of prevalence and risk factors. Clin Infect Dis 2003;36:131–139.CrossRefGoogle ScholarPubMed
2.Eady, EA, Cove, JH. Staphylococcal resistance revisited. Community-acquired methicillin resistant Staphylococcus aureus. An emerging problem for the management of skin and soft tissue infections. Curr Opin Infect Dis 2003;16:103–124.Google Scholar
3.Tambyah, PA, Habib, AG, Ng, TM, Goh, H, Kumarasinghe, G. Community-acquired methicillin-resistant Staphylococcus aureus infection in Singapore is usually “healthcare associated.” Infect Control Hosp Epidemiol 2003;24:436–438.Google Scholar
4.Calfee, DP, Durbin, LJ, Germanson, TP, Toney, DM, Smith, EB, Farr, BM. Spread of methicillin-resistant Staphylococcus aureus (MRSA) among household contacts of individuals with nosocomially acquired MRSA. Infect Control Hosp Epidemiol 2003;24:422–426.Google Scholar
5.Herold, BC, Immergluck, LC, Maranan, MC, et al.Community-acquired methicillin-resistant Staphylococcus aureus in children with no identified predisposing risk. JAMA 1998;279:593–598.Google Scholar
6.Adcock, PM, Pastor, P, Medley, F, Patterson, JE, Murphy, TV. Methicillin-resistant Staphylococcus aureus in two child care centers. J Infect Dis 1998;178:577–580.Google Scholar
7.Lindenmayer, JM, Schoenfeld, S, O'Grady, R, Carney, JK. Methicillin-resistant Staphylococcus aureus in a high school wrestling team and the surrounding community. Arch Intern Med 1998;158:895–899.CrossRefGoogle Scholar
8.L'Heriteau, F, Lucet, JC, Scanvic, A, Bouvet, E. Community-acquired methicillin-resistant Staphylococcus aureus and familial transmission. JAMA 1999;282:1038–1039.Google Scholar
9.Baggett, HC, Hennessy, TW, Leman, R, et al.An outbreak of community-onset methicillin-resistant Staphylococcus aureus skin infections in southwestern Alaska. Infect Control Hosp Epidemiol 2003;24:397–402.CrossRefGoogle ScholarPubMed
10.Rosdahl, VT, Knudsen, AM. The decline of methicillin resistance among Danish Staphylococcus aureus strains. Infect Control Hosp Epidemiol 1991;12:83–88.Google Scholar
11.Rosdahl, VT, Schenheyder, HC, Westh, H. Staphylococcus aureus: 33-year epidemiology in Denmark. From hospital epidemics to endogenous infections [in Danish]? Ugeskr Laeger 1994;156:2057–2065.Google Scholar
12.Danish Integrated Antimicrobial Resistance Monitoring and Research Programme. Use of Antimicrobial Agents and Occurrence of Antimicrobial Resistance in Bacteria From Food Animals, Foods and Humans in Denmark. Copenhagen, Denmark: Danish Institute for Food and Veterinary Research; 2003. Available at www.dfvf.dk.Google Scholar
13.Eriksen, NH, Espersen, F, Rosdahl, VT, Jensen, K. Evaluation of methods for the detection of nasal carriage of Staphylococcus aureus. APMIS 1994;102:407–412.Google Scholar
14.Skov, R, Eisberg, CS, Moller, JK, Gahrn-Hansen, B, Schenheyder, HC, Westh, H. Dissemination of a MRSA clone in Denmark. Presented at the 9th International Symposium on Staphylococci and Staphylococcal Infections; June 14-17, 2000; Kolding, Denmark. Abstract 221.Google Scholar
15.Faria, NA, Oliveira, DC, Westh, H, et al. Epidemiology of emerging methicillin-resistant Staphylococcus aureus in Denmark: a nationwide study in a low prevalence country. J Clin Microbiol. In press.Google Scholar
16.Zimakoff, J, Rosdahl, VT, Petersen, W, Scheibel, J. Supplementary treatment of recurrent familial furunculosis [in Danish]. Maanedsskrifl for Praktisk Laegegerning 1989;67:343–350.Google Scholar
17.Coello, R, Jimenez, J, Garcia, M, et al.Prospective study of infection, colonization and carriage of methicillin-resistant Staphylococcus aureus in an outbreak affecting 990 patients. Eur J Clin Microbiol Infect Dis 1994;13:74–81.Google Scholar
18.Witte, W, Cuny, C, Strommenger, B, Braulke, C, Heuck, D. Emergence of a new community acquired MRSA strain in Germany. Euro Surveillance 2004;9:1–2.Google Scholar
19.Aires de Sousa, M, Bartzavali, C, Spiliopoulou, I, Sanches, IS, Crisòstomo, MI, de Lencastre, H. Two international methicillin-resistant Staphylococcus aureus clones endemic in a university hospital in Patras, Greece. J Clin Microbiol 2003;41:2027–2032.CrossRefGoogle Scholar
20.Faden, H, Ferguson, S. Community-acquired methicillin-resistant Staphylococcus aureus and intrafamily spread of pustular disease. Pediatr Infect Dis J 2001;20:554–555.Google Scholar
21.Jones, TF, Kellum, ME, Porter, SS, Bell, M, Schaffner, W. An outbreak of community-acquired foodborne illness caused by methicillin-resistant Staphylococcus aureus. Emerg Infect Dis 2002;8:82–84.Google Scholar
22.Quagliarello, B, Céspedes, C, Miller, M, et al.Strains of Staphylococcus aureus obtained from drug-use networks are closely linked. Clin Infect Dis 2002;35:671–677.Google Scholar
23.Doebbeling, BN, Reagan, DR, Pfaller, MA, Houston, AK, Hollis, RJ, Wenzel, RP. Long-term efficacy of intranasal mupirocin ointment: a prospective cohort study of Staphylococcus aureus carriage. Arch Intern Med 1994;154:1505–1508.Google Scholar