[Antibiotic ointments and methicillin-resistant Staphylococcus aureus with a reservoir in a healthcare worker in a tertiary hospital]

Abstract

Background: Methicillin-resistant Staphylococcus aureus (MRSA) has become an important hospital-acquired pathogen, with transfer of the organism from a carrier or infected patient to uninfected patients by the hands or clothing of staff as the main mode of transmission.

Methods: Investigation of a cluster of new cases of MRSA resistant to mupirocin and fusidic acid, using epidemiological and microbiological resources.

Results: From September 2010 to February 2012, sixteen patients had at least one culture positive for MRSA resistant to mupirocin and fusidic acid. Some not apparently related cases and outbreaks appeared. By analysing cultures taken from patients and staff using pulsed-field gel electrophoresis, it was demonstrated that most likely this situation was started by an auxiliary nurse who was a carrier of the MRSA. Healthcare worker decontamination using oral antibiotic therapy was unsuccessful. Eventually, the situation was controlled by placing the carrier in a different job, with no further cases to date (September, 2012).

Conclusion: This report illustrates the risk of nosocomial transmission linked to care delivered by healthcare workers.

Keywords: Electroforesis en campo pulsado; Fusidic acid; Healthcare worker; Methicillin-resistant Staphylococcus aureus; Mupirocin; Mupirocina; Pulsed field gel electrophoresis; Staphylococcus aureus resistente a la meticilina; Trabajador sanitario; Ácido fusídico.