Outbreak of CA-MRSA in patients with neuro-development disorders requiring ICU admission




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Intensive Care Medicine, 1432-1238, Vol. 38, Supl., 2012, p. S49

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Springer Nature

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INTRODUCTION. CA-MRSA in Latin America has become an emergent microorganism causing severe infections requiring ICU admission. This epidemic outbreak is especially present in a group of patients bearing characteristics associated with hospital care. OBJECTIVES. Description of the epidemiological characteristics related to genotyping, phenotyping, and management of a CA-MRSA outbreak in patients treated at an ICU in Bogota, Colombia. METHODS. Case studies and controls. RESULTS. Of 100 persons treated at a healthcare institution for neurodevelopmental diseases, 50 consulted to emergency departments between September 2008 and January 2009 with skin infections (n:15) arthritis (n:2) or pneumonia (n:1). In 15 of these patients CAMRSA was isolated, 53 % (8) in blood. Identified through genotyping such as SSCmec Ivc clone USA300, with lukF-PV/tukS-PV genes seq, sek and bsaB. 100 % were PVL positive. 10 (73 %) patients evidenced neuropsychiatric alterations with behavioral trauma such as coprophagy, shared use of hygiene elements, and recurrent skin lesions. 1 with pneumonia and 2 with skin infections required ICU admission. CA-MRSA was not documented in cultures of physicians, nurses, and therapists in charge of patient care at the institute. Decolonization of patients with CA-MRSA was conducted with nasal Mupirocin and Chlorhexidine baths for 7 days, and contact isolation was instaured. Global mortality was 20 % being lowest in the group that received empirical treatment with Vancomycin, compared to those that used Oxacillin-Clindamycin (33.3 vs. 66.6 %). CONCLUSIONS. USA300 is a potential cause of CA-MRSA outbreaks requiring ICU admission. REFERENCE(S). 1. Vandenesch F, et al. Emerg Infect Dis. 2003;9:978–84. 2. Campbell K, et al. J Clin Microbiol. 2004;50–4053. 3. Wagenlehner F, et al. J Hosp Infect. 2007;67:114–20.

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