A Prolonged Outbreak of MethicillinResistant Staphylococcus aureus in the Burn Unit of a Tertiary Medical Center

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Abstract
Objective: To report an outbreak of methicillinresistant Staphylococcus aureus (MRSA) in our burn unit and the steps we used to eradicate the organism. Design and Sething: Outbreak investigation in the burn unit of a 900-bed tertiary-care medical center. Outbreak: Between March and June 1993, MRSA was isolated from 10 patients in our burn unit. All isolates had identical antibiograms and chromosomal DNA patterns. Control Measures: Infection control personnel encouraged healthcare workers to wash their hands after each patient contact. The unit cohorted all infected or colonized patients, placed each affected patient in isolation, and, if possible, transferred the patient to another unit. Despite these measures, new cases occurred. Infection control personnel obtained nares cultures from 56 healthcare workers, 3 of whom carried the epidemic MRSA strain. One healthcare worker cared for six affected patients, and one cared for five patients. We treated the three healthcare workers with mupirocin. Subsequently, no additional patients became colonized or infected with the epidemic MRSA strain. Conclusions: The outbreak ended after we treated healthcare workers who carried the epidemic strain with mupirocin. This approach is not appropriate in all settings. However, we felt it was justified in this case because of a persistent problem after less intrusive measures.