A double outbreak of exfoliative toxin-producing strains of Staphylococcus aureus in a maternity unit

Epidemiol Infect. 1994 Feb;112(1):103-14. doi: 10.1017/s0950268800057460.

Abstract

This report describes a double outbreak of staphylococcal scalded skin syndrome (SSSS) in which two distinct tetracycline-resistant strains of Staphylococcus aureus producing different exfoliative toxins were involved. In the first phase the daytime staff of the delivery unit and eczematous skin conditions in midwives were implicated as the probable source. In the second phase a source within a post-natal ward was suggested with local cross-infection. In the final phase both sources were epidemiologically linked to cases of SSSS. Because early discharge was the policy of the unit many cases presented in the community rather than in the hospital. Confirmation of epidemiological findings was provided by additional laboratory studies. Two distinct strains of S. aureus could be defined, differing in phage-typing patterns, the exfoliative toxin produced, plasmid profile, cadmium resistance and bacteriocin production. Strict care in hand washing with a chlorhexidine-containing detergent was an important control measure.

MeSH terms

  • Adult
  • Carrier State / epidemiology
  • Carrier State / microbiology
  • Cross Infection / epidemiology*
  • Cross Infection / microbiology
  • Cross Infection / transmission
  • Disease Outbreaks*
  • Exfoliatins / biosynthesis
  • Humans
  • Infant, Newborn
  • Infectious Disease Transmission, Professional-to-Patient
  • Midwifery
  • Nurseries, Hospital*
  • Obstetrics and Gynecology Department, Hospital
  • Staphylococcal Skin Infections / epidemiology*
  • Staphylococcal Skin Infections / microbiology
  • Staphylococcal Skin Infections / transmission
  • Staphylococcus aureus / classification*
  • Staphylococcus aureus / drug effects
  • Staphylococcus aureus / metabolism
  • Tetracycline Resistance
  • United Kingdom / epidemiology

Substances

  • Exfoliatins