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Controlling a Multicenter Outbreak Involving the New York/Japan Methicillin-Resistant Staphylococcus aureus Clone

Published online by Cambridge University Press:  02 January 2015

G. W. Coombs ,
H. Van Gessel ,
J. C. Pearson ,
M.-R. Godsell ,
F. G. O'Brien  and
K. J. Christiansen
G. W. Coombs*
Affiliation:
Department of Microbiology and Infectious Diseases, Path West Laboratory Medicine, Western Australia—Royal Perth Hospital, Western Australia, Australia School of Biomedical Sciences, Curtin University of Technology, Western Australia, Australia Gram-Positive Bacteria Typing and Research Unit, Western Australia, Australia
H. Van Gessel
Affiliation:
Department of Microbiology and Infectious Diseases, Path West Laboratory Medicine, Western Australia—Royal Perth Hospital, Western Australia, Australia Clinical Services, Royal Perth Hospital, Perth, Western Australia, Australia
J. C. Pearson
Affiliation:
Department of Microbiology and Infectious Diseases, Path West Laboratory Medicine, Western Australia—Royal Perth Hospital, Western Australia, Australia Gram-Positive Bacteria Typing and Research Unit, Western Australia, Australia
M.-R. Godsell
Affiliation:
Clinical Services, South West Area Health Service, Bunbury, Western Australia, Australia
F. G. O'Brien
Affiliation:
School of Biomedical Sciences, Curtin University of Technology, Western Australia, Australia Gram-Positive Bacteria Typing and Research Unit, Western Australia, Australia
K. J. Christiansen
Affiliation:
Department of Microbiology and Infectious Diseases, Path West Laboratory Medicine, Western Australia—Royal Perth Hospital, Western Australia, Australia School of Biomedical Sciences, Curtin University of Technology, Western Australia, Australia Gram-Positive Bacteria Typing and Research Unit, Western Australia, Australia
*
Department of Microbiology and Infectious Diseases, Royal Perth Hospital, Box X2213 GPO, Perth, Western Australia 6847 (geoffrey.coombs@health.wa.gov.au)
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Abstract

Objective.

To describe the control of an outbreak of infection and colonization with the New York/Japan methicillin-resistant Staphylococcus aureus (MRSA) clone in multiple healthcare facilities, and to demonstrate the importance of making an MRSA management policy involving molecular typing of MRSA into a statewide public health responsibility.

Setting.

A range of healthcare facilities, including 2 metropolitan teaching hospitals and a regional hospital, as well as several community hospitals and long-term care facilities in a nonmetropolitan healthcare region.

Interventions.

A comprehensive, statewide MRSA epidemiological investigation and management policy.

Results.

In May 2005, there were 3 isolates referred to the Western Australian Gram-Positive Bacteria Typing and Research Unit that were identified as the New York/Japan MRSA clone, a pandemic MRSA clone with the ability to spread and replace existing clones in a region. Subsequent investigation identified 28 additional cases of infection and/or colonization dating from 2002 onward, including 1 involving a colonized healthcare worker (HCW) who had previously been hospitalized overseas. Of the 31 isolates detected, 25 were linked epidemiologically and via molecular typing to the isolate recovered from the colonized HCW. Four isolates appeared to have been introduced separately from overseas. Although the isolate from the single remaining case patient was genetically indistinct from the isolates that spread within Western Australia, no specific epidemiological link could be established. The application of standard outbreak management strategies reduced further spread.

Conclusions.

The elimination of the New/York Japan MRSA clone in a healthcare region demonstrates the importance of incorporating MRSA management policy into statewide public health programs. The mainstays of such programs should include a comprehensive and effective outbreak identification and management policy (including pre-employment screening of HCWs, where applicable) and MRSA clone identification by multilocus sequence typing.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 28 , Issue 7 , July 2007 , pp. 845 - 852
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2007

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