Outbreak of CA-MRSA in patients with neuro-development disorders requiring ICU admission

INTRODUCTION. CA-MRSA in Latin America has become an emergent microorganism causing severe infections requiring ICU admission. This epidemic outbreak is especially present in a group of patients bearing characteristics associated with hospital care. OBJECTIVES. Description of the epidemiological characteristics related to genotyping, phenotyping, and management of a CA-MRSA outbreak in patients treated at an ICU in Bogota, Colombia. METHODS. Case studies and controls. RESULTS. Of 100 persons treated at a healthcare institution for neurodevelopmental diseases, 50 consulted to emergency departments between September 2008 and January 2009 with skin infections (n:15) arthritis (n:2) or pneumonia (n:1). In 15 of these patients CAMRSA was isolated, 53 % (8) in blood. Identified through genotyping such as SSCmec Ivc clone USA300, with lukF-PV/tukS-PV genes seq, sek and bsaB. 100 % were PVL positive. 10 (73 %) patients evidenced neuropsychiatric alterations with behavioral trauma such as coprophagy, shared use of hygiene elements, and recurrent skin lesions. 1 with pneumonia and 2 with skin infections required ICU admission. CA-MRSA was not documented in cultures of physicians, nurses, and therapists in charge of patient care at the institute. Decolonization of patients with CA-MRSA was conducted with nasal Mupirocin and Chlorhexidine baths for 7 days, and contact isolation was instaured. Global mortality was 20 % being lowest in the group that received empirical treatment with Vancomycin, compared to those that used Oxacillin-Clindamycin (33.3 vs. 66.6 %). CONCLUSIONS. USA300 is a potential cause of CA-MRSA outbreaks requiring ICU admission. REFERENCE(S). 1. Vandenesch F, et al. Emerg Infect Dis. 2003;9:978–84. 2. Campbell K, et al. J Clin Microbiol. 2004;50–4053. 3. Wagenlehner F, et al. J Hosp Infect. 2007;67:114–20.

• Autores: Molano, D.; Villabon, M.; Escobar, J.; Vanegas, N.; Jordi, R.
• Tipo de recurso: Article of journal
• Fecha de publicación: 2012
• Institución: Universidad El Bosque
• Repositorio: Repositorio U. El Bosque
• Idioma: eng
• OAI Identifier: oai:repositorio.unbosque.edu.co:20.500.12495/7076
• Acceso en línea: http://hdl.handle.net/20.500.12495/7076; https://doi.org/10.1007/s00134-012-2683-0
• Rights: openAccess
• License: Acceso abierto