Nosocomial transmission of methicillin-resistant Staphylococcus aureus from a mother to her preterm quadruplet infants

Am J Infect Control. 2002 May;30(3):170-3. doi: 10.1067/mic.2002.119819.

Abstract

Background: Patient-to-patient transmission of methicillin-resistant Staphylococcus aureus (MRSA) in neonatal intensive care units (NICUs) has been well described. We report the first documented outbreak of probable transmission of MRSA from a mother to 3 of her preterm quadruplet infants postnatally.

Methods: Routine surveillance of clinical microbiologic laboratory reports revealed an increased incidence of MRSA infections in our NICU, including 3 of 4 preterm quadruplets. Surveillance cultures of the anterior nares of all patients and the quadruplets' parents were performed to detect MRSA carriage. The isolates were typed by pulsed-field gel electrophoresis with the restriction endonuclease SmaI. Infection control strategies included mupirocin treatment and contact isolation precautions for infected/colonized infants.

Results: Clinical cultures from infants A, C, and D and surveillance cultures of the quadruplets' mother and 2 additional unrelated infants grew the same clone of MRSA. The mother's only identified risk factors for MRSA acquisition were 2 prepartum hospitalizations related to the multiple gestation and previous treatment with antibiotics. All anterior nares cultures were negative for MRSA after mupirocin treatment.

Conclusions: Use of gowns and gloves by the family members of women with multiple gestations should be recommended to prevent transmission of potential pathogens in the NICU.

MeSH terms

  • Adult
  • Amino Acid Sequence
  • Carrier State
  • Cross Infection / drug therapy
  • Cross Infection / epidemiology
  • Cross Infection / microbiology
  • Cross Infection / transmission*
  • Disease Outbreaks
  • Electrophoresis, Gel, Pulsed-Field
  • Female
  • Humans
  • Infant, Newborn
  • Infant, Premature, Diseases / drug therapy
  • Infant, Premature, Diseases / microbiology*
  • Infection Control
  • Intensive Care Units, Neonatal
  • Methicillin Resistance*
  • Mupirocin / therapeutic use
  • Pregnancy
  • Pregnancy Complications / microbiology*
  • Quadruplets*
  • Staphylococcal Infections / drug therapy
  • Staphylococcal Infections / transmission*
  • Staphylococcus aureus / isolation & purification*

Substances

  • Mupirocin