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

Published online by Cambridge University Press:  15 May 2009

J. Dave ,
S. Reith ,
J. Q. Nash ,
R. R. Marples  and
C. Dulake
J. Dave
Affiliation:
Leeds Public Health Laboratory, Bridle Path, York Road, Leeds LS15 7TR
S. Reith
Affiliation:
Staphylococcus Reference Laboratory, Hospital and Respiratory Infection Division, PHLS Central Public Health Laboratory, 61 Colindale Avenue, London NW9 5HT
J. Q. Nash
Affiliation:
Ashford Public Health Laboratory, The William Harvey Hospital, Kennington Road, Willesborough, Ashford, Kent TN24 0LZ
R. R. Marples
Affiliation:
Staphylococcus Reference Laboratory, Hospital and Respiratory Infection Division, PHLS Central Public Health Laboratory, 61 Colindale Avenue, London NW9 5HT
C. Dulake
Affiliation:
Ashford Public Health Laboratory, The William Harvey Hospital, Kennington Road, Willesborough, Ashford, Kent TN24 0LZ
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Summary

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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.

Type
Research Article
Information
Epidemiology & Infection , Volume 112 , Issue 1 , February 1994 , pp. 103 - 114
Copyright
Copyright © Cambridge University Press 1994

References

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