Skip to main content

Outbreak of Staphylococcal Infection in Two Hospital Nurseries Traced to a Single Nasal Carrier

  • Anusha Belani (a1), Robert J. Sherertz (a1), Marsha L. Sullivan (a1), Beverly A. Russell (a1) and Peter D. Reumen (a1)...

In late January and early February 1983, an outbreak of skin infections (7 of 145 infants) caused by a penicillin/erythromycin resistant strain of Staphylococcus aureus (SA), phage type 3A/3C, occurred in our newborn nursery. A week following the first cluster of infections, another nursery outbreak due to SA with the same antibiogram occurred in a nearby community hospital (11 of 114 infants). Subsequently, a second cluster of infections with the same SA was identified at our nursery. The epidemic strain was carried in the anterior nares of a single nurse who worked at both hospital nurseries on alternate weeks. Investigation revealed that the nurse had an upper respiratory tract infection during each of these outbreaks—simulating “a cloud baby.” No further infections have occurred since this nurse was treated and her SA nasal carrier state eliminated.

Corresponding author
Division of Infectious Disease, Box J-277 JHMHC, University of Florida, Gainesville, FL 32610
Hide All
1.Parker, MT, Kennedy, J: The source of infection in Pemphigus Neonatorum. J Hyg 1949; 47:213219.
2.Shaffer, TE, Baldwin, JN, Rheins, MS, et al: Staphylococcal infections in newborn infants: I. Study of an epidemic among infants and nursing mothers. Pediatrics 1956; 18:750761.
3.Shaffer, TE, Sylvester, RF Jr, Baldwin, JN, et al: Staphylococcal infections in newborn infants: II Report of 19 epidemics caused by an identical strain of Staphylococcus pyogenes. Am J Public Health 1957; 47:990995.
4.Albert, S, Baldwin, R, Czekajewski, S, et al: Bullous impetigo due to group II S. aureus. Am J Dis Child 1970; 12:1013.
5.Light, IJ, Brackvogel, V, Walton, RL, et al: An epidemic of bullous impetigo arising from a central admission-observation nursery. Pediatrics 1972; 49:1521.
6.Anthony, BF, Giuliano, DM, Oh, W: Nursery outbreak of staphylococcal scalded skin syndrome. Am J Dis Child 1972; 124:4144.
7.Florman, AL, Holzman, RS: Nosocomial scalded skin syndrome. Am J Dis Child 1980; 134:10431045.
8.Wolinsky, E, Lipsitz, PJ, Mortimer, EA, et al: Acquisition of staphylococci by newborns: Direct versus indirect transmission. Lancet 1960; 2:620622.
9.Mortimer, E, Lipsitz, PJ, Wolinsky, E, et al: Transmission of staphylococci between newborns. Am J Dis Child 1962; 104:289296.
10.Haley, RW, Bregman, DA: The role of understaffing and overcrowding in recurrent outbreaks of staphylococcal infection in a neonatal special care unit. J Infect Dis 1982; 145:875885.
11.Fekety, RF, Buchbinder, L, Shaffer, EL, et al: Control of an outbreak of staphylococcal infections among mothers and infants in a suburban hospital. Am J Public Health 1958; 48:298310.
12.Hare, R, Thomas, CGA: The transmission of Staphylococcus aureus. Br Med J 1956; 2:840844.
13.Rafai, B, Juler, GL: An epidemiologic study of postoperative staphylococcal wound infections in patients having vascular procedures. Am Surg 1978; 44:346351.
14.Calia, FM, Wolinsky, E, Mortimer, EA Jr, et al: Importance of the carrier state as a source of Staphylococcus aureus in wound sepsis. J Hyg 1969; 67:4957.
15.Nakashima, AK, Allen, JR, Martone, WJ, et al: Epidemic bullous impetigo in a nursery due to a nasal carrier of Staphylococcus aureus: Role of epidemiology and control measures. Infect Control 1984; 5:326331.
16.Tanner, EI, Bullin, J, Bullin, CH, et al: An outbreak of postoperative sepsis due to a staphylococcal disperser. J Hyg 1980; 85:219225.
17.Bryan, CS, Wilson, RS, Meade, P, et al: Topical antibiotic ointments for staphylococcal nasal carriers: Survey of current practices and comparison of bacitracin and vancomycin ointments. Infect Control 1980; 1:153156.
18.McAnally, TP, Lewis, MR, Brown, DR: Effect of rifampin and bacitracin on nasal carriers of Staphylococcus aureus. Antimicrob Agents Chemother 1984; 25:422426.
19.White, A: Relation between quantitative nasal cultures and dissemination of Staphylococci. J Lab Clin Med 1961; 58:273277.
20.Bethune, DW, Blowers, R, Parker, M, et al: Dispersal of Staphylococrus aureus by patients and surgical staff. Lancet 1965; 1:480483.
21.Eichenwald, H, Kotsevalov, O, Fasso, LA: The “Cloud baby”: An example of bacterial-viral interaction. Am J Dis Child 1960; 100:161173.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *


Altmetric attention score