Skip to main content

Spread of a Methicillin-Resistant Staphylococcus aureus ST80-IV Clone in a Danish Community

  • Tinna Urth (a1), Gitte Juul (a1), Robert Skov (a2) and Henrik C. Schønheyder (a1) (a3)
Abstract<span class='bold'>Objective:</span>

We report a community cluster of methicillin-resistant Staphylococcus aureus (MRSA) in Denmark with emphasis on routes of transmission and infection control measures. The objective is to extend knowledge of MRSA in a community setting where a nosocomial link could effectively be ruled out.

<span class='bold'>Design:</span>

Population-based observational study from November 1997 until June 2003.

<span class='bold'>Setting:</span>

North Jutland County, with approximately 495,000 inhabitants.

<span class='bold'>Subjects:</span>

The cluster encompassed 46 individuals and 26 households.

<span class='bold'>Interventions:</span>

Infection control measures included repeated visits to affected households by an infection control nurse who undertook screening for carriage among all household members and provided a program for decolonization.

<span class='bold'>Results:</span>

The causal strain was identical to a newly described international clone, ST80; SSCmec type IV; and Panton–Valentine leukocidin positive. Plausible routes of transmission included household contact and contact at work, kindergarten, and school. We did not detect a nosocomial source or any secondary cases in hospitals. Transmission by healthcare contact outside the hospital was plausible for three cases. We found evidence that the clone was introduced on more than one occasion to immigrant families from the Middle East. A 5-day decolonization program was successful at first attempt in 15 of 16 households that could be evaluated.

<span class='bold'>Conclusions:</span>

Despite the described infection control measures, we continued to see new cases, underlining a need for a national policy to contain MRSA in the community.

Corresponding author
Department of Clinical Microbiology, Aalborg Hospital, P.O. Box 365, DK-9100 Aalborg, Denmark.
Hide All
1.Salgado CD, Farr BM, Calfee DP. Community-acquired methicillin-resistant Staphylococcus aureus: a meta-analysis of prevalence and risk factors. Clin Infect Dis 2003;36:131139.
2.Eady EA, Cove JH. Staphylococcal resistance revisited. Community-acquired methicillin resistant Staphylococcus aureus. An emerging problem for the management of skin and soft tissue infections. Curr Opin Infect Dis 2003;16:103124.
3.Tambyah PA, Habib AG, Ng TM, Goh H, Kumarasinghe G. Community-acquired methicillin-resistant Staphylococcus aureus infection in Singapore is usually “healthcare associated.” Infect Control Hosp Epidemiol 2003;24:436438.
4.Calfee DP, Durbin LJ, Germanson TP, Toney DM, Smith EB, Farr BM. Spread of methicillin-resistant Staphylococcus aureus (MRSA) among household contacts of individuals with nosocomially acquired MRSA. Infect Control Hosp Epidemiol 2003;24:422426.
5.Herold BC, Immergluck LC, Maranan MC, et al.Community-acquired methicillin-resistant Staphylococcus aureus in children with no identified predisposing risk. JAMA 1998;279:593598.
6.Adcock PM, Pastor P, Medley F, Patterson JE, Murphy TV. Methicillin-resistant Staphylococcus aureus in two child care centers. J Infect Dis 1998;178:577580.
7.Lindenmayer JM, Schoenfeld S, O'Grady R, Carney JK. Methicillin-resistant Staphylococcus aureus in a high school wrestling team and the surrounding community. Arch Intern Med 1998;158:895899.
8.L'Heriteau F, Lucet JC, Scanvic A, Bouvet E. Community-acquired methicillin-resistant Staphylococcus aureus and familial transmission. JAMA 1999;282:10381039.
9.Baggett HC, Hennessy TW, Leman R, et al.An outbreak of community-onset methicillin-resistant Staphylococcus aureus skin infections in southwestern Alaska. Infect Control Hosp Epidemiol 2003;24:397402.
10.Rosdahl VT, Knudsen AM. The decline of methicillin resistance among Danish Staphylococcus aureus strains. Infect Control Hosp Epidemiol 1991;12:8388.
11.Rosdahl VT, Schenheyder HC, Westh H. Staphylococcus aureus: 33-year epidemiology in Denmark. From hospital epidemics to endogenous infections [in Danish]? Ugeskr Laeger 1994;156:20572065.
12.Danish Integrated Antimicrobial Resistance Monitoring and Research Programme. Use of Antimicrobial Agents and Occurrence of Antimicrobial Resistance in Bacteria From Food Animals, Foods and Humans in Denmark. Copenhagen, Denmark: Danish Institute for Food and Veterinary Research; 2003. Available at
13.Eriksen NH, Espersen F, Rosdahl VT, Jensen K. Evaluation of methods for the detection of nasal carriage of Staphylococcus aureus. APMIS 1994;102:407412.
14.Skov R, Eisberg CS, Moller JK, Gahrn-Hansen B, Schenheyder HC, Westh H. Dissemination of a MRSA clone in Denmark. Presented at the 9th International Symposium on Staphylococci and Staphylococcal Infections; June 14-17, 2000; Kolding, Denmark. Abstract 221.
15.Faria NA, Oliveira DC, Westh H, et al. Epidemiology of emerging methicillin-resistant Staphylococcus aureus in Denmark: a nationwide study in a low prevalence country. J Clin Microbiol. In press.
16.Zimakoff J, Rosdahl VT, Petersen W, Scheibel J. Supplementary treatment of recurrent familial furunculosis [in Danish]. Maanedsskrifl for Praktisk Laegegerning 1989;67:343350.
17.Coello R, Jimenez J, Garcia M, et al.Prospective study of infection, colonization and carriage of methicillin-resistant Staphylococcus aureus in an outbreak affecting 990 patients. Eur J Clin Microbiol Infect Dis 1994;13:7481.
18.Witte W, Cuny C, Strommenger B, Braulke C, Heuck D. Emergence of a new community acquired MRSA strain in Germany. Euro Surveillance 2004;9:12.
19.Aires de Sousa M, Bartzavali C, Spiliopoulou I, Sanches IS, Crisòstomo MI, de Lencastre H. Two international methicillin-resistant Staphylococcus aureus clones endemic in a university hospital in Patras, Greece. J Clin Microbiol 2003;41:20272032.
20.Faden H, Ferguson S. Community-acquired methicillin-resistant Staphylococcus aureus and intrafamily spread of pustular disease. Pediatr Infect Dis J 2001;20:554555.
21.Jones TF, Kellum ME, Porter SS, Bell M, Schaffner W. An outbreak of community-acquired foodborne illness caused by methicillin-resistant Staphylococcus aureus. Emerg Infect Dis 2002;8:8284.
22.Quagliarello B, Céspedes C, Miller M, et al.Strains of Staphylococcus aureus obtained from drug-use networks are closely linked. Clin Infect Dis 2002;35:671677.
23.Doebbeling BN, Reagan DR, Pfaller MA, Houston AK, Hollis RJ, Wenzel RP. Long-term efficacy of intranasal mupirocin ointment: a prospective cohort study of Staphylococcus aureus carriage. Arch Intern Med 1994;154:15051508.
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? *


Full text views

Total number of HTML views: 0
Total number of PDF views: 1 *
Loading metrics...

Abstract views

Total abstract views: 64 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 18th December 2017. This data will be updated every 24 hours.