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Outbreak of Multiple Strains of Methicillin-resistant Staphylococcus aureus in the Neonatal Intensive Care Unit

Mitsunori MASUDA1)2), Yoshiki KUSAMA1)3), Isamu HONMA1)4), Hirokazu GOTO1)2)5) and Syoichi ONODERA1)5)
1)Infection Control Team, Fuji City General Hospital, 2)Infection Control Room, Fuji City General Hospital, 3)Department of Pediatrics, Fuji City General Hospital, 4)Department of Nursing, Fuji City General Hospital, 5)Department of Urology, Fuji City General Hospital


The number of patients with methicillin-resistant Staphylococcus aureus (MRSA) colonization in our neonatal intensive care unit (NICU) has rapidly increased since March 2016; therefore, we suspected horizontal MRSA transmission. Although infection control practices, including strengthening contact precaution measures and patient cohorting were implemented, MRSA transmission was not controlled. We decontaminated MRSA-colonized staff and treated the patients; subsequently, MRSA transmission and increased colonization were controlled. Cases of MRSA infection were not observed during the period when infection control measures were effectively applied. A PCR-based ORF typing (POT) analysis revealed eight different MRSA strains, and four-eights of strains transmitted in NICU. The suspected transmission route generated using the two-dimensional career map system (2DCM-web) completely coincided with POT results. Therefore, 2DCM-web is believed to be a useful tool to detect transmission routes. In the present case, our prompt actions terminated an outbreak and prevented subsequent MRSA infections. MRSA infection can be contracted from external sources at any time; therefore, NICU staff should regularly perform infection control practices.

Key words:Methicillin-resistant Staphylococcus aureus (MRSA), Infection Control Team (ICT), Neonatal Intensive Care Unit (NICU), PCR-based ORF typing (POT), 2 dimension career map system (2DCM-web)

e-mail: masuda_mitsunori@st.city.fuji.shizuoka.jp

Received: October 31, 2017
Accepted: June 18, 2018

33 (5):230─235,2018

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