Neonatal staphylococcal scalded skin syndrome: clinical and outbreak containment review.

Hdl Handle:
http://hdl.handle.net/10147/206293
Title:
Neonatal staphylococcal scalded skin syndrome: clinical and outbreak containment review.
Authors:
Neylon, Orla; O'Connell, Nuala H; Slevin, Barbara; Powell, James; Monahan, Regina; Boyle, Liz; Whyte, Dominic; Mannix, Mai; McElligott, Fiona; Kearns, Angela M; Philip, Roy K
Affiliation:
Department of Paediatrics, Mid-Western Regional Hospital, Dooradoyle, Limerick,, Ireland.
Citation:
Eur J Pediatr. 2010 Dec;169(12):1503-9. Epub 2010 Jul 13.
Journal:
European journal of pediatrics
Issue Date:
31-Jan-2012
URI:
http://hdl.handle.net/10147/206293
DOI:
10.1007/s00431-010-1252-1
PubMed ID:
20625909
Abstract:
Staphylococcal scalded skin syndrome (SSSS) is a toxin-mediated exfoliating skin condition predominated by desquamation and blistering. Neonatal outbreaks have already been reported; however, our outbreak highlights the potential for SSSS following neonatal health promotion measures such as intra-muscular vitamin K administration and metabolic screening (heel prick) as well as effective case containment measures and the value of staff screening. Between February and June 2007, five confirmed cases of neonatal SSSS were identified in full-term neonates born in an Irish regional maternity hospital. All infants were treated successfully. Analysis of contact and environmental screening was undertaken, including family members and healthcare workers. Molecular typing on isolates was carried out. An outbreak control team (OCT) was assembled and took successful prospective steps to prevent further cases. All five Staphylococcus aureus isolates tested positive for exfoliative toxin A, of which two distinct strains were identified on pulsed-field gel electrophoresis analysis. Two cases followed staphylococcal inoculation during preventive measures such as intra-muscular vitamin K administration and metabolic screening (heel prick). None of the neonatal isolates were methicillin resistant. Of 259 hospital staff (70% of staff) screened, 30% were colonised with S. aureus, and 6% were positive for MRSA carriage. This is the first reported outbreak of neonatal SSSS in Ireland. Effective case containment measures and clinical value of OCT is demonstrated. Results of staff screening underlines the need for vigilance and compliance in hand disinfection strategies in maternity hospitals especially during neonatal screening and preventive procedures.
Language:
eng
MeSH:
Cross Infection/diagnosis/*microbiology/prevention & control; Disease Outbreaks/prevention & control/*statistics & numerical data; Female; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases/epidemiology/*microbiology/prevention & control; Infection Control/methods/*organization & administration; Infectious Disease Transmission, Professional-to-Patient/prevention &; control/statistics & numerical data; Ireland/epidemiology; Male; Neonatal Screening/instrumentation/methods; Staphylococcal Scalded Skin Syndrome/*epidemiology/microbiology/prevention &; control/*transmission; Staphylococcus aureus/isolation & purification
ISSN:
1432-1076 (Electronic); 0340-6199 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorNeylon, Orlaen_GB
dc.contributor.authorO'Connell, Nuala Hen_GB
dc.contributor.authorSlevin, Barbaraen_GB
dc.contributor.authorPowell, Jamesen_GB
dc.contributor.authorMonahan, Reginaen_GB
dc.contributor.authorBoyle, Lizen_GB
dc.contributor.authorWhyte, Dominicen_GB
dc.contributor.authorMannix, Maien_GB
dc.contributor.authorMcElligott, Fionaen_GB
dc.contributor.authorKearns, Angela Men_GB
dc.contributor.authorPhilip, Roy Ken_GB
dc.date.accessioned2012-01-31T16:47:32Z-
dc.date.available2012-01-31T16:47:32Z-
dc.date.issued2012-01-31T16:47:32Z-
dc.identifier.citationEur J Pediatr. 2010 Dec;169(12):1503-9. Epub 2010 Jul 13.en_GB
dc.identifier.issn1432-1076 (Electronic)en_GB
dc.identifier.issn0340-6199 (Linking)en_GB
dc.identifier.pmid20625909en_GB
dc.identifier.doi10.1007/s00431-010-1252-1en_GB
dc.identifier.urihttp://hdl.handle.net/10147/206293-
dc.description.abstractStaphylococcal scalded skin syndrome (SSSS) is a toxin-mediated exfoliating skin condition predominated by desquamation and blistering. Neonatal outbreaks have already been reported; however, our outbreak highlights the potential for SSSS following neonatal health promotion measures such as intra-muscular vitamin K administration and metabolic screening (heel prick) as well as effective case containment measures and the value of staff screening. Between February and June 2007, five confirmed cases of neonatal SSSS were identified in full-term neonates born in an Irish regional maternity hospital. All infants were treated successfully. Analysis of contact and environmental screening was undertaken, including family members and healthcare workers. Molecular typing on isolates was carried out. An outbreak control team (OCT) was assembled and took successful prospective steps to prevent further cases. All five Staphylococcus aureus isolates tested positive for exfoliative toxin A, of which two distinct strains were identified on pulsed-field gel electrophoresis analysis. Two cases followed staphylococcal inoculation during preventive measures such as intra-muscular vitamin K administration and metabolic screening (heel prick). None of the neonatal isolates were methicillin resistant. Of 259 hospital staff (70% of staff) screened, 30% were colonised with S. aureus, and 6% were positive for MRSA carriage. This is the first reported outbreak of neonatal SSSS in Ireland. Effective case containment measures and clinical value of OCT is demonstrated. Results of staff screening underlines the need for vigilance and compliance in hand disinfection strategies in maternity hospitals especially during neonatal screening and preventive procedures.en_GB
dc.language.isoengen_GB
dc.subject.meshCross Infection/diagnosis/*microbiology/prevention & controlen_GB
dc.subject.meshDisease Outbreaks/prevention & control/*statistics & numerical dataen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHumansen_GB
dc.subject.meshInfanten_GB
dc.subject.meshInfant, Newbornen_GB
dc.subject.meshInfant, Newborn, Diseases/epidemiology/*microbiology/prevention & controlen_GB
dc.subject.meshInfection Control/methods/*organization & administrationen_GB
dc.subject.meshInfectious Disease Transmission, Professional-to-Patient/prevention &en_GB
dc.subject.meshcontrol/statistics & numerical dataen_GB
dc.subject.meshIreland/epidemiologyen_GB
dc.subject.meshMaleen_GB
dc.subject.meshNeonatal Screening/instrumentation/methodsen_GB
dc.subject.meshStaphylococcal Scalded Skin Syndrome/*epidemiology/microbiology/prevention &en_GB
dc.subject.meshcontrol/*transmissionen_GB
dc.subject.meshStaphylococcus aureus/isolation & purificationen_GB
dc.titleNeonatal staphylococcal scalded skin syndrome: clinical and outbreak containment review.en_GB
dc.contributor.departmentDepartment of Paediatrics, Mid-Western Regional Hospital, Dooradoyle, Limerick,, Ireland.en_GB
dc.identifier.journalEuropean journal of pediatricsen_GB
dc.description.provinceMunster-

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