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Community-associated methicillin-resistant staphylococcus aureus outbreaks seen among healthy neonates
In 2004, hospitals in Chicago and Los Angeles County reported clusters of skin infections caused by methicillin-resistant Staphylococcus aureus (MRSA) among otherwise healthy infants within the first month after birth.
Unlike health care–associated MRSA, isolates from these patients were resistant only to β-lactams and macrolides, as is common among community-associated MRSA.
Details of the outbreaks are reported in the 31 March issue of the Morbidity and Mortality Weekly Report.
Dr. J. Watson, from the Chicago Department of Pubic Health, and associates describe 11 MRSA infections that occurred in Chicago between May and December, 10 of which occurred after hospital discharge. Ten patients were treated with topical mupirocin or neosporin, and 3 were also treated with oral cefaclor, cephalexin, or clindamycin.
Cultures of nasal specimens obtained from 135 staff members who worked with newborns revealed positive results for 1 physician and 1 nurse. Both were restricted from work until they completed a course of intranasal mupirocin, and results of a second nasal culture were negative for MRSA.
In 2004, Los Angeles County received reports of 2 clusters of MRSA among newborns, 1 between November and December 2003 and 1 between May and June 2004, totalling 11 cases. Onset was between 1 and 17 days after hospital discharge. Eight newborns were hospitalized and treated with parenteral antimicrobials, whereas the only treatment administered to the remaining 3 infants was topical antibiotics.
Isolates subjected to PFGE showed that the USA300-0114 strain was associated with the outbreaks in both locations.
All the patients from the 2 hospitals recovered. The authors note that 16 of the 22 infants were born by cesarean delivery, and 20 were male, although the significance of these associations is unclear.