ABSTRACT
BACKGROUND: The optimal approach to managing institutional scabies outbreaks has yet to be defined. We report on outbreak managements are needed. METHODS: We report on a large outbreak of scabies in three acute care wards in a tertiary university teaching hospital in the Netherlands. RESULTS: The outbreak potentially effected 460 patients and 185 health care workers who had been exposed to the index patient. CONCLUSION: Containment of an outbreak relies on a quick and strict implementation of appropriate infection control measures and should include simultaneous treatment of all infested persons and exposed contacts to prevent secondary spread and prolonged post-intervention surveillance.
Subject(s)
Health Personnel , Infection Control/methods , Infectious Disease Transmission, Patient-to-Professional , Scabies/transmission , Adult , Disease Outbreaks , Female , Hospitals, Teaching , Humans , Netherlands , Scabies/epidemiologyABSTRACT
Staphylococcus aureus is an important Gram-positive bacterial pathogen producing many secreted and cell surface-localized virulence factors. Here we report that the staphylococcal thiol-disulfide oxidoreductase DsbA is essential for stable biogenesis of the ComGC pseudopilin. The signal peptidase ComC is indispensable for ComGC maturation and optimal cell surface exposure.
Subject(s)
Bacterial Proteins/metabolism , Membrane Proteins/metabolism , Protein Disulfide Reductase (Glutathione)/metabolism , Serine Endopeptidases/metabolism , Staphylococcus aureus/enzymology , Staphylococcus aureus/metabolism , Gene ExpressionABSTRACT
Patients with the blistering disease, epidermolysis bullosa (EB), frequently suffer from chronic wounds that become colonized by pathogenic bacteria, such as Staphylococcus aureus. To determine S. aureus colonization rates in patients with EB, swabs were collected from the anterior nares, throats and wounds of 52 Dutch patients with EB. Swabs were also collected from nares and throats of 13 healthcare workers who occasionally meet the sampled patients with EB. All EB patients with chronic wounds and 75% of the patients without chronic wounds were colonized with S. aureus. In contrast, 39% of the sampled healthcare workers were colonized with S. aureus. Typing revealed a high degree of genetic diversity of 184 collected S. aureus isolates. Autoinoculation of S. aureus in individual patients with EB was shown to occur frequently, whereas transmission of S. aureus between patients with EB is apparently rare. There was no evidence for S. aureus transmission between patients with EB and healthcare workers.