Trial to control an outbreak of Panton-Valentine leukocidin-positive methicillin-resistant Staphylococcus aureus at a boarding school in Japan

Masaaki Higashiyama, Teruyo Ito, Xiao Han, Junichiro Nishiyama, Akemi Tanno, Toshiko Wada, Youichi Funaoka, Yusuke Yoshida, Kei Mikita, Tomomichi Ogawa, Yasushi Okusa, Koki Kaku, Junichi Hatada, Keiichi Hiramatsu, Akihiko Kawana

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: Our retrospective investigation of methicillin-resistant Staphylococcus aureus (MRSA) infection at a hospital in Japan around 2007 suggested dissemination of community-associated MRSA (CA-MRSA) strains among healthy students in a Japanese boarding school, which frequently caused skin disease and exhibited the same antibiogram patterns. Methods: Active surveillance of skin diseases for 6 months after May 2008, examination of MRSA carriage in selected high-risk groups, and investigation of their life circumstances, including environmental cultures, were conducted in the school. Furthermore, we strengthened hygiene practices and improved recognized risk factors from November 2008 and observed the occurrence of skin diseases and MRSA carriage rate for the evaluation of infection controls. Results: We identified 21 patients with skin diseases in whom MRSA strains were isolated. MRSA colonization rates in 3 selected groups ranged from 7.6% to 36.6%. The rates of both skin disease and MRSA carriage decreased significantly after infection controls were introduced. Genetic analysis revealed a main dissemination of a PVL-positive SCCmec IVc clone (41/47 isolates in total), presenting as a different pulsed-field type than USA300. Conclusion: This first report of a PVL-positive CA-MRSA outbreak in Japan demonstrates systematic management of dissemination by conducting surveillance in a closed community.

Original languageEnglish
Pages (from-to)858-865
Number of pages8
JournalAmerican Journal of Infection Control
Volume39
Issue number10
DOIs
Publication statusPublished - 2011 Dec 1
Externally publishedYes

Keywords

  • Closed community
  • colonization
  • outbreak
  • skin and soft tissue infection
  • surveillance

ASJC Scopus subject areas

  • Epidemiology
  • Health Policy
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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    Higashiyama, M., Ito, T., Han, X., Nishiyama, J., Tanno, A., Wada, T., Funaoka, Y., Yoshida, Y., Mikita, K., Ogawa, T., Okusa, Y., Kaku, K., Hatada, J., Hiramatsu, K., & Kawana, A. (2011). Trial to control an outbreak of Panton-Valentine leukocidin-positive methicillin-resistant Staphylococcus aureus at a boarding school in Japan. American Journal of Infection Control, 39(10), 858-865. https://doi.org/10.1016/j.ajic.2011.02.010