Hospital Transmission of Community-Acquired Methicillin-Resistant Staphylococcus aureus among Postpartum Women

• Published in: Clinical infectious diseases Vol. 37; no. 10; pp. 1313 - 1319
• Main Authors: Saiman, Lisa, Keefe, Mary O, Graham, Philip L., Wu, Fann, Salim, Battouli Saïd, Kreiswirth, Barry, LaSala, Anita, Schlievert, Patrick M., Latta, Phyllis Della
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 15.11.2003; University of Chicago Press
• Subjects: Abscesses; Anti-Bacterial Agents - pharmacology; Bacterial diseases; Biological and medical sciences; Case-Control Studies; Children; Community-Acquired Infections - epidemiology; Community-Acquired Infections - microbiology; Community-Acquired Infections - transmission; Cross Infection - epidemiology; Cross Infection - microbiology; Cross Infection - transmission; Disease Outbreaks; Disease transmission; Epidemiology; Female; Gynecology. Andrology. Obstetrics; Human bacterial diseases; Humans; Infections; Infectious diseases; Major Articles; Mammary gland diseases; Mastitis; Medical sciences; Methicillin Resistance - physiology; Methicillin resistant staphylococcus aureus; Microbial Sensitivity Tests; Non tumoral diseases; Postpartum Period; Predisposing factors; Risk Factors; Staphylococcal Infections - epidemiology; Staphylococcal Infections - microbiology; Staphylococcal Infections - transmission; Staphylococcal infections, streptococcal infections, pneumococcal infections; Staphylococcus; Staphylococcus aureus; Staphylococcus aureus - drug effects; Virulence Factors - analysis; Nosocomial infection; Skin disease; Pustulosis dermatosis; Transmission; Cellulitis; Wound; Bacteria; Micrococcales; Female; Micrococcaceae; Mammary gland; Hospital; Woman; Staphylococcus aureus; Human; Postoperative; Mastitis; Abscess; Puerperium; Infection; Mammary gland diseases; Community acquired infection; Risk factor; Bacteriosis; Soft tissue; Adipose tissue disorders; Delivery; Staphylococcal infection
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1086/379022

Infections caused by community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) are being increasingly observed in patients who lack traditional risk factors. We described 8 postpartum women who developed skin and soft-tissue infections caused by MRSA at a mean time of 23 days (range, 4-73 days) after delivery. Infections included 4 cases of mastitis (3 of which progressed to breast abscess), a postoperative wound infection, cellulitis, and pustulosis. The outbreak strains were compared with the prototype CA-MRSA strain MW2 and found to be indistinguishable by pulsed-field gel electrophoresis. All were spa type 131, all contained the staphylococcal chromosomal cassette mec type IV, and all expressed Panton-Valentine leukocidin and staphylococcal enterotoxins C and H. The route of transmission was not discovered: the results of surveillance cultures of samples obtained from employees of the hospital, the hospital environment, and newborns were negative for the outbreak strain. We report that MW2, which was previously limited to the midwestern United States, has spread to the northeastern United States and has become a health care-associated pathogen.