Multiple methicillin-resistant Staphylococcus aureus strains as a cause for a single outbreak of severe disease in hospitalized neonates

Gary J. Noel, Barry N. Kreiswirth, Barry N. Kreiswirth, Mirjana Nesin, Steve Projan, William Eisner, Diane J. Bauer, Herminia De Lencastre, Agnes M. Sa Figueiredo, Alexander Tomasz

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Methicillin-resistant Staphylococcus aureus (MRSA) is an important cause of nosocomial infection. Outbreaks of infection caused by these pathogens are generally considered to be traceable to introduction of single strains into a hospital population. A large outbreak of bacteremic disease that recently occurred in our neonatal intensive care unit (11 episodes in 10 patients) involved 9 low birth weight infants and was associated with serious infection (4 episodes of meningitis). To determine the role of a single point source in this outbreak, isolates were characterized based on phenotypic and genotypic analyses. Phenotypic analysis included assessing hemolytic activity, phage typing, antimicrobial susceptibility testing and methicillin resistance population analysis. Genotypic analysis included assessment of plasmid profiles, dotblot hybridization, restriction enzyme fragment pattern analysis and hybridization analysis of chromosomal DNA using a panel of staphylococcal gene probes. This analysis established that at least two distinct strains of MRSA were responsible for disease during this outbreak. This experience demonstrates the potential for MRSA to cause severe disease in the neonatal intensive care unit and indicates that the epidemiology of MRSA outbreaks is more complex than the spread of a single strain of bacteria.

Original languageEnglish (US)
Pages (from-to)184-188
Number of pages5
JournalPediatric Infectious Disease Journal
Issue number3
StatePublished - Mar 1992
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Microbiology (medical)
  • Infectious Diseases


  • Genotypic analysis of methieillin resistant Stuphyhlococeus aureus
  • Methiollin resistant Staphylocosaureeus
  • Neonatal baeteremia
  • Nosofonual infertions


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