Control of Methicillin-Resistant Strains Associated With a Hospital Outbreak Involving Contamination From Anesthesia Equipment Using UV-C.
Sara A Ochoa, Ariadnna Cruz-Córdova, Jetsi Mancilla-Rojano, Gerardo Escalona-Venegas, Veronica Esteban-Kenel, Isabel Franco-Hernández, Israel Parra-Ortega, José Arellano-Galindo, Rigoberto Hernández-Castro, Citlalli F Perez-López, Daniela De la Rosa-Zamboni, Juan Xicohtencatl-Cortes
Author Information
Sara A Ochoa: Laboratorio de Investigación en Bacteriología Intestinal, Hospital Infantil de México Federico Gómez, Ciudad de México, Mexico.
Ariadnna Cruz-Córdova: Laboratorio de Investigación en Bacteriología Intestinal, Hospital Infantil de México Federico Gómez, Ciudad de México, Mexico.
Jetsi Mancilla-Rojano: Laboratorio de Investigación en Bacteriología Intestinal, Hospital Infantil de México Federico Gómez, Ciudad de México, Mexico.
Gerardo Escalona-Venegas: Laboratorio de Investigación en Bacteriología Intestinal, Hospital Infantil de México Federico Gómez, Ciudad de México, Mexico.
Veronica Esteban-Kenel: Laboratorio de Investigación en Bacteriología Intestinal, Hospital Infantil de México Federico Gómez, Ciudad de México, Mexico.
Isabel Franco-Hernández: Laboratorio Central de Bacteriología, Hospital Infantil de México Federico Gómez, Ciudad de México, Mexico.
Israel Parra-Ortega: Laboratorio Central de Bacteriología, Hospital Infantil de México Federico Gómez, Ciudad de México, Mexico.
José Arellano-Galindo: Departamento de Infectología, Hospital Infantil de México Federico Gómez, Ciudad de México, Mexico.
Rigoberto Hernández-Castro: Departamento de Ecología de Agentes Patógenos, Hospital General Dr. Manuel Gea González, Ciudad de México, Mexico.
Citlalli F Perez-López: Departamento de Epidemiología Hospitalaria, Hospital Infantil de México Federico Gómez, Ciudad de México, Mexico.
Daniela De la Rosa-Zamboni: Departamento de Epidemiología Hospitalaria, Hospital Infantil de México Federico Gómez, Ciudad de México, Mexico.
Juan Xicohtencatl-Cortes: Laboratorio de Investigación en Bacteriología Intestinal, Hospital Infantil de México Federico Gómez, Ciudad de México, Mexico.
Methicillin-resistant (MRSA) is considered an opportunistic pathogen in humans and is mainly associated with healthcare-associated infections (HCAIs). This bacterium colonizes the skin and mucous membranes of healthy people and causes frequent hospital outbreaks. The aim of this study was to perform molecular typing of the staphylococcal cassette chromosome (SCC) and loci as wells as to establish the pulsotypes and clonal complexes (CCs) for MRSA and methicillin-sensitive . (MSSA) outbreaks associated with the operating room (OR) at a pediatric hospital. Twenty-five clinical strains of (19 MRSA and 6 MSSA strains) were recovered from the outbreak (patients, anesthesia equipment, and nasopharyngeal exudates from external service anesthesia technicians). These clinical . strains were mainly resistant to benzylpenicillin (100%) and erythromycin (84%) and were susceptible to vancomycin and nitrofurantoin. The SCC type II was amplified in 84% of the . strains, and the most frequent type of the locus was , which was amplified in 72% of the strains; however, the and genes were mainly detected in MSSA strains. A pulsed-field gel electrophoresis (PFGE) analysis grouped the 25 strains into 16 pulsotypes (P), the most frequent of which was P1, including 10 MRSA strains related to the anesthesia equipment, external service anesthesia technicians, and hospitalized patients. Multilocus sequence typing (MLST) identified 15 sequence types (STs) distributed in nine CCs. The most prevalent ST was ST1011, belonging to CC5, which was associated with the SCC type II and type. We postulate that the external service anesthesia technicians were MRSA carriers and that these strains were indirectly transmitted from the contaminated anesthesia equipment that was inappropriately disinfected. Finally, the MRSA outbreak was controlled when the anesthesia equipment disinfection was improved and hand hygiene was reinforced.
