ORIGINAL ARTICLES

Methicillin-resistant Staphylococcus aureus infections among healthy full-term newborns

L James^1,2, R J Gorwitz², R C Jones¹, J T Watson¹, J C Hageman², D B Jernigan², Y Lord³, N Caballes³, C Cortes¹, R G Golash⁴, J S Price⁴ and S I Gerber¹

¹ Chicago Department of Public Health, Chicago, Illinois, USA
² Centers for Disease Control and Prevention, Atlanta, Georgia, USA
³ St Anthony Hospital, Chicago, Illinois, USA
⁴ Illinois Department of Public Health Division of Laboratories, Chicago, Illinois, USA

Correspondence to:
Dr L James, Ministry of Health, College of Medicine Building, 16 College Road, Singapore 169854; lynjames36{at}yahoo.com

Objective: Methicillin-resistant Staphylococcus aureus (MRSA) strains have emerged in the community, causing disease among healthy people lacking traditional risk factors for MRSA infection. This article describes an outbreak of MRSA among healthy full-term newborns.

Design: Cases were identified and corresponding medical information collected. Telephone interviews were conducted with mothers of cases ands surveillance cultures from mothers and newborns were performed. MRSA isolates were genotyped.

Setting: Hospital in Chicago, Illinois, USA.

Participants: Newborns, their mothers and hospital healthcare workers.

Intervention: Nursery infection control practices were enhanced. The MRSA-colonised healthcare workers received intranasal mupirocin.

Main outcome: Within 4–23 days of birth, 11 newborns were identified with pustules, vesicles or blisters located on the head, groin, perineum, ears, legs, chin and trunk. All received antimicrobials and recovered without incident.

Results: None of 432 peripartum women, one of 399 newborns, and two of 135 healthcare workers were nasal MRSA carriers. Available isolates from six patients, two healthcare workers, and one from an MRSA-colonised newborn were similar by pulsed-field gel electrophoresis. Other than contact with the hospital, no common exposures of MRSA transmission were identified.

Conclusions: MRSA strains that initially emerged in the community are now causing disease in healthcare settings. Providers should be aware that MRSA can cause skin infections among healthy newborns. Adherence to standard infection control practices is important to prevent transmission of MRSA in nurseries.

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