A five year outbreak of methicillin-susceptible Staphylococcus
aureus phage type 53,85 in a regional neonatal unit
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abstract
We identified a 5-year outbreak of a methicillin-susceptible Staphylococcus aureus (MSSA)
strain, affecting 202 babies on a neonatal unit, by routine weekly phage typing all S. aureus
isolates. Multiple staged control measures including strict emphasis on hand hygiene,
environmental and staff surveillance sampling, and application of topical hexachlorophane
powder failed to end the outbreak. S. aureus PT 53,85 (SA5385) was found on opened packs
of Stomahesive®, used as a neonatal skin protectant. Only following the implementation of
aseptic handling of Stomahesive®, and the use of topical mupirocin for staff nasal carriers of
SA5385, and for babies colonized or infected with S. aureus, did the isolation rate of SA5385
decline. DNA fingerprinting indicated that [ges ]95% of SA5385 isolates were clonal. In vitro
death rates of SA5385 on Stomahesive® with human serum were significantly lower than on
Stomahesive® alone (P = 0·04), and on cotton sheet with serum (P = 0·04), highlighting the
potential of this material as a survival niche. Phage typing remains a valuable, inexpensive and
simple method for monitoring nosocomial MSSA infection.
