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An Outbreak of Staphylococcus aureus in a Pediatric Cardiothoracic Surgery Unit

Published online by Cambridge University Press:  02 January 2015

Stefan Weber ,
Loreen A. Herwaldt ,
Louise-Anne McNutt ,
Paul Rhomberg ,
Pierre Vaudaux ,
Michael A. Pfaller  and
Trish M. Perl
Stefan Weber
Affiliation:
Department of Internal Medicine, University of Iowa College of Medicine, Iowa City, Iowa
Loreen A. Herwaldt*
Affiliation:
Department of Internal Medicine, University of Iowa College of Medicine, Iowa City, Iowa Program of Hospital Epidemiology, University of Iowa Hospitals and Clinics, Iowa City, Iowa
Louise-Anne McNutt
Affiliation:
Department of Epidemiology, University at Albany, State University of New York, Rensselaer, New York
Paul Rhomberg
Affiliation:
Department of Pathology, University of Iowa College of Medicine, Iowa City, Iowa
Pierre Vaudaux
Affiliation:
Division of Infectious Diseases, University Hospital of Geneva, Geneva, Switzerland
Michael A. Pfaller
Affiliation:
Department of Pathology, University of Iowa College of Medicine, Iowa City, Iowa
Trish M. Perl
Affiliation:
Department of Internal Medicine, University of Iowa College of Medicine, Iowa City, Iowa
*
Department of Internal Medicine, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242-1081
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Abstract

Objective:

To investigate an outbreak of Staphylococcus aureus surgical-site infections.

Design:

Case–control study.

Setting:

Pediatric cardiothoracic surgery service of a tertiary-care university medical center.

Method:

Molecular typing was used to identify healthcare workers who carried the epidemic strain.

Results:

Three children acquired surgical-site infections caused by a single strain of S. aureus. Fourteen (25%) of the staff members in the operating room and 17 (11%) on nursing units carried the epidemic strain (P = 01). A case–control study identified 4 healthcare workers who were associated statistically with the outbreak, 2 of whom (a cardiothoracic surgeon and a perfusionist) carried the epidemic strain in their nares. The surgeon also carried the epidemic strain on his hands. Each staff member who carried the epidemic strain was treated with mupirocin; those carrying the strain on their hands were required to wash their hands with chlorhexidine. The surgeon was not allowed to perform surgery until 2 of his hand cultures did not grow S. aureus.

Conclusions:

Only three children were infected with the epidemic strain, but it was disseminated widely among staff who cared for children who underwent cardiothoracic surgery. No additional cases were identified after staff members who carried the epidemic strain were decolonized. Both classic epidemiologic methods and molecular typing techniques were necessary to identify the source and extent of this outbreak.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 23 , Issue 2 , February 2002 , pp. 77 - 81
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2002

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