Healthcare worker-related MRSA cluster in a German neonatology level III ICU: a true European story

Int J Hyg Environ Health. 2014 Mar;217(2-3):307-11. doi: 10.1016/j.ijheh.2013.07.006. Epub 2013 Jul 25.

Abstract

Here we investigated a cluster of eight newly Methicillin-resistant Staphylococcus aureus (MRSA)-colonized neonates at an ICU, and present data on molecular strain characterization as well as the source identification process in which we analyze the impact of MRSA-colonized HCWs. Molecular strain characterization revealed a unique pattern which was identified as spa-type t 127--an extremely rare strain type in Germany. Environmental sampling and screening of parents of colonized neonates proved negative. However, staff screening identified one healthcare worker (HCW; 1/134) belonging to a group of recently employed Romanian HCWs who was colonized with the spa 127 strain. Subsequent screening also detected MRSA in 9/51 Romanian HCWs (18%) and 7/9 (14% of all) isolates showed the same molecular pattern as the index case (spa/PFGE type). All carriers were successfully decolonized, after which no new patient cases occurred. As a result, we have now implemented a universal screening programme of all new employees as part of our infection control management strategy. MRSA-colonized HCWs can act as a source for in hospital transmission. Since HCWs from high endemic countries are particular prone to being colonized, they may pose a risk to patients.

Keywords: Cross transmission; Infection control; Multi resistant bacteria; Neonatology.

MeSH terms

  • Adult
  • Carrier State*
  • Cross Infection / epidemiology
  • Cross Infection / etiology
  • Cross Infection / microbiology
  • Cross Infection / prevention & control
  • Cross Infection / transmission*
  • Disease Outbreaks*
  • Germany / epidemiology
  • Health Personnel*
  • Humans
  • Infant, Newborn
  • Intensive Care Units, Neonatal*
  • Mass Screening
  • Methicillin-Resistant Staphylococcus aureus*
  • Neonatology
  • Staphylococcal Infections / epidemiology
  • Staphylococcal Infections / microbiology
  • Staphylococcal Infections / prevention & control
  • Staphylococcal Infections / transmission*