Blanket suppression therapy for healthcare workers (HCW) following a PVL-MSSA outbreak in a neonatal unit: The right decision?
PHE ePoster Library. Atkin S. Sep 12, 2017; 186445; 60
Sara Atkin
Sara Atkin
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Abstract BackgroundStaphylococcus aureus is a leading cause of healthcare-associated infections, with resistant strains the frequent cause of outbreaks. Persistent carriage is associated with an increased risk of nosocomial infection and carriage rates amongst HCWs are higher than the general population. Preventing transmission in healthcare settings through good Infection Prevention Control (IPC) practices is a key priority within acute trusts.Investigation Over a 3-month period, 3 MSSA infections with the same antibiograms were identified in premature babies across two neonatal units of the same trust. One baby was born in unusual circumstances and subsequent died. As initial epidemiological investigations identified some overlaps and there were small differences in MSSA genotype, the cases were thought not to be directly related. Enhanced IPC measures, including occupational health advice to staff, were implemented. No staff had symptoms or history suggestive of PVL infection.ResultsWhole-genome sequencing of 2/3 available isolates found them to be highly similar. As cases occurred at different time points, the likely conclusion was deemed to be a colonised HCW. Due to difficulties in establishing all staff contacts, the death of one baby and sensitivities of identifying a positive staff member, a decision was made to provide suppression therapy to all staff without prior screening.ConclusionThe uptake of suppression therapy among staff was >90% and there have been no further cases. Although the source remains unknown and an extended period of vigilance continued, provision of blanket treatment avoided the possibility of a single staff member being implicated in this outbreak.
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