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. 2012 Nov 20;1(1):37.
doi: 10.1186/2047-2994-1-37.

The use of typing methods and infection prevention measures to control a bullous impetigo outbreak on a neonatal ward

Maike Koningstein  1 , Leon Groen, Kathelijn Geraats-Peters, Suzanne Lutgens, Ariene Rietveld, Petr Jira, Jan Kluytmans, Sabine C de Greeff, Mirjam Hermans, Peter M Schneeberger
Affiliations

The use of typing methods and infection prevention measures to control a bullous impetigo outbreak on a neonatal ward

Maike Koningstein et al. Antimicrob Resist Infect Control. .

Abstract

Background: We describe an outbreak of Bullous Impetigo (BI), caused by a (methicillin susceptible, fusidic acid resistant) Staphylococcus aureus (SA) strain, spa-type t408, at the neonatal and gynaecology ward of the Jeroen Bosch hospital in the Netherlands, from March-November 2011.

Methods: We performed an outbreak investigation with revision of the hygienic protocols, MSSA colonization surveillance and environmental sampling for MSSA including detailed typing of SA isolates. Spa typing was performed to discriminate between the SA isolates. In addition, Raman-typing was performed on all t408 isolates.

Results: Nineteen cases of BI were confirmed by SA positive cultures. A cluster of nine neonates and three health care workers (HCW) with SA t408 was detected. These strains were MecA-, PVL-, Exfoliative Toxin (ET)A-, ETB+, ETAD-, fusidic acid-resistant and methicillin susceptible. Eight out of nine neonates and two out of three HCW t408 strains yielded a similar Raman type. Positive t408 HCW were treated and infection control procedures were reinforced. These measures stopped the outbreak.

Conclusions: We conclude that treatment of patients and HCW carrying a predominant SA t408, and re-implementing and emphasising hygienic measures were effective to control the outbreak of SA t408 among neonates.

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Figures

Figure 1
Figure 1
Number of total cases in the Impetigo Bullosa outbreak, Jeroen Bosch Hospital, 's Hertogenbosch, The Netherlands, March-November 2011.
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References

    1. Razmjou RG, Willemsen SP, Koning S. et al.Determinants of regional differences in the incidence of impetigo. Environ Res. 2009;109:590–593. doi: 10.1016/j.envres.2009.03.003. - DOI - PubMed
    1. Koning S, Mohammedamin RSA, van der Wouden JC. et al.Impetigo: incidence and treatment in Dutch general practice in 1987 and 2001 - results from two national surveys. Br J Dermatol. 2005;154:239–242. - PubMed
    1. Lina G, Gillet Y, Vandenesch F. et al.Toxin involvement in staphylococcal scalded skin syndrome. Clin Infect Dis. 1997;25:1369–1373. doi: 10.1086/516129. - DOI - PubMed
    1. Johnston GA. Treatment of bullous impetigo and the staphylococcal scalded skin syndrome in infants. Expert Review of Anti-infective Therapy. 2004;2:439–446. doi: 10.1586/14787210.2.3.439. - DOI - PubMed
    1. Yamasaki O, Yamaguchi T, Sugai M. et al.Clinical manifestations of staphylococcal scalded-skin syndrome depend on serotypes of exfoliative toxins. J Clin Microbiol. 2005;43:1890–1893. doi: 10.1128/JCM.43.4.1890-1893.2005. - DOI - PMC - PubMed

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