Journal Article

1210. Investigating a Staphylococcus aureus Outbreak in a Clinical Intensive Care Unit: What Is the Role of the Mobile Phones?

Sara Shafferman Levin, Anna, Boszczowski, Icaro, Guimaraes, Thais, Rossi, Flavia, Martins, Roberta C R, dos Santos, Sania Alves, Pereira, Gaspar C O, Espinoza, Evelyn Patricia Sanchez, Pinheiro Freire, Maristela, Costa, Silvia F, Neto, Lauro Viera Perdigão, Risek, Camila, Franco, Maria Renata Gomes

2019

Overview

Background Staphylococcus aureus (Sa) outbreaks are serious infections that if not controlled in time can be life-threating. The aim of this study was to describe the investigation and control of a Sa outbreak in an intensive care unit including analysis of MP. Methods During a microbiological research of MP conducted in December 2018 in a clinical intensive care unit (ICU) of a tertiary university hospital two patients had an MRSA infection. Since this unit had not reported MRSA infections during the last year it was recognized as an outbreak. The CDC criteria was applied to define MRSA colonization and infection. Hand hygiene (HH) adhesion in this unit was 47%,it has 9 beds and 30 Healthcare professionals (HP). Nasal Swab (NS) of all the HPs and of the patients in the same unit as well. HP’s MP were also analyzed. The samples were subjected to MALDI-TOF (Biomerieux), phenotypical tests, PCR for detection of gene coA and mecA, pulsed-field gel electrophoresis (PFGE), and whole-genome sequence to access resistance, virulence profile and sequence type. Feedback of microbiology results, reinforcement of hand hygiene and MP cleaning was discussed with the unit staff. Results A total of 34 samples were collected, 25 were Sa, 13 NS of all HPs and patients, 7 from the MPs and 3 from HPs hands. During the time of the outbreak 5 patients were in the unit. Patients with infection by MRSA (n = 2), had Methicillin-susceptible Sa in their NSs. Another patient that from the same unit had a MRSA in the NS that when submitted to PFGE was seen to be closely related with the MRSA that originated the outbreak. The patients isolates were assigned to different STs and they had more virulent and resistance genes in comparison with two samples of MPs. The Sa recovered from the MPs belonged to the same ST, same resistance gene and same virulent genes. Figure 1, Table1. Since the feedback to the unit no cases of MRSA have been reported in the last 4 months. Conclusion The outbreak was controlled using simply measures (feedback, reinforcement of HH and MP cleaning). The ST398 from the MP has already been described in outbreaks in literature. It seems that MP can be a reservoir for Sa There was more than one Sa lineage in the ICU. Our findings highlighted the need of rethinking the MP cleaning policy in our hospital. Disclosures All authors: No reported disclosures.

• Publisher: Oxford University Press
• Subject: Abstracts / Feedback / Genes / Intensive care / Staphylococcus infections