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Epidemic Bullous Impetigo in a Nursery Due to a Nasal Carrier of Staphylococcus aureus: Role of Epidemiology and Control Measures

Published online by Cambridge University Press:  02 January 2015

Allyn K. Nakashima ,
James R. Allen ,
William J. Martone ,
Brian D. Plikaytis ,
Beth Storer ,
Larry M. Cook  and
Stephen P. Wright
Allyn K. Nakashima*
Affiliation:
Hospital Infections Program, Center for Infectious Diseases, Centers for Disease Control, Public Health Service, Department of Health and Human Services, Atlanta, Georgia Division of Bacterial Diseases, Center for Infectious Diseases, Centers for Disease Control, Public Health Service, Department of Health and Human Services, Atlanta, Georgia Korsair-Children's Hospital, Louisville, Kentucky Department of Pediatrics, University of Louisville School of Medicine, Louisville, Kentucky
James R. Allen
Affiliation:
Hospital Infections Program, Center for Infectious Diseases, Centers for Disease Control, Public Health Service, Department of Health and Human Services, Atlanta, Georgia Division of Bacterial Diseases, Center for Infectious Diseases, Centers for Disease Control, Public Health Service, Department of Health and Human Services, Atlanta, Georgia Korsair-Children's Hospital, Louisville, Kentucky Department of Pediatrics, University of Louisville School of Medicine, Louisville, Kentucky
William J. Martone
Affiliation:
Hospital Infections Program, Center for Infectious Diseases, Centers for Disease Control, Public Health Service, Department of Health and Human Services, Atlanta, Georgia Division of Bacterial Diseases, Center for Infectious Diseases, Centers for Disease Control, Public Health Service, Department of Health and Human Services, Atlanta, Georgia Korsair-Children's Hospital, Louisville, Kentucky Department of Pediatrics, University of Louisville School of Medicine, Louisville, Kentucky
Brian D. Plikaytis
Affiliation:
Hospital Infections Program, Center for Infectious Diseases, Centers for Disease Control, Public Health Service, Department of Health and Human Services, Atlanta, Georgia Division of Bacterial Diseases, Center for Infectious Diseases, Centers for Disease Control, Public Health Service, Department of Health and Human Services, Atlanta, Georgia Korsair-Children's Hospital, Louisville, Kentucky Department of Pediatrics, University of Louisville School of Medicine, Louisville, Kentucky
Beth Storer
Affiliation:
Hospital Infections Program, Center for Infectious Diseases, Centers for Disease Control, Public Health Service, Department of Health and Human Services, Atlanta, Georgia Division of Bacterial Diseases, Center for Infectious Diseases, Centers for Disease Control, Public Health Service, Department of Health and Human Services, Atlanta, Georgia Korsair-Children's Hospital, Louisville, Kentucky Department of Pediatrics, University of Louisville School of Medicine, Louisville, Kentucky
Larry M. Cook
Affiliation:
Hospital Infections Program, Center for Infectious Diseases, Centers for Disease Control, Public Health Service, Department of Health and Human Services, Atlanta, Georgia Division of Bacterial Diseases, Center for Infectious Diseases, Centers for Disease Control, Public Health Service, Department of Health and Human Services, Atlanta, Georgia Korsair-Children's Hospital, Louisville, Kentucky Department of Pediatrics, University of Louisville School of Medicine, Louisville, Kentucky
Stephen P. Wright
Affiliation:
Hospital Infections Program, Center for Infectious Diseases, Centers for Disease Control, Public Health Service, Department of Health and Human Services, Atlanta, Georgia Division of Bacterial Diseases, Center for Infectious Diseases, Centers for Disease Control, Public Health Service, Department of Health and Human Services, Atlanta, Georgia Korsair-Children's Hospital, Louisville, Kentucky Department of Pediatrics, University of Louisville School of Medicine, Louisville, Kentucky
*
Hospital Infections Program, Center for Infectious Diseases, Centers for Disease Control, Atlanta, GA 30333
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Abstract

From September 14, 1981 to February 28, 1982, an epidemic of bullous impetigo caused by a penicillin/tetracycline resistant strain of Staphylococcus aureus, phage type 3A/3C, occurred in a newborn nursery in Louisville, Kentucky. Twenty of 1,181 (1.7%) infants at risk developed disease during the six-month epidemic period. Clinically all case-infants had bullous impetigo skin lesions. One infant developed staphylococcal septicemia. No infant died. An epidemiologic investigation identified a nurse as having significantly greater contact with case-infants than control-infants (p=0.0013). She was also found to be a nasal carrier of the epidemic strain. Infection control measures appeared to decrease infant-to-infant transmission via the hands of non-colonized nurses, but did not affect transmission from the nurse carrying the epidemic strain to infants. No cases of bullous impetigo have occurred since this nurse was temporarily removed from the nursery for treatment.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 5 , Issue 7 , July 1984 , pp. 326 - 331
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1984

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