OUTBREAK IN A NEW-YORK-CITY TEACHING HOSPITAL BURN CENTER CAUSED BY THE IBERIAN EPIDEMIC CLONE OF MRSA

During an 18-month period in a burn center (January 1995 through June 1996), 109 single-patient MRSA isolates were identified and 102 isolat es (94%) were available for DNA fingerprinting. Ninety-nine isolates ( 97%) carried the mecA polymorph I and Tn554 type E, Pulsed-field elect rophoresis (PFGE) identified 8 patterns, of which 60 isolates were of pattern F2, The I:E:F clonal type and a stable drug multidrug resistan t phenotype (sensitivity only to trimethoprim/sulfamethoxazole and van comycin) indicated that these isolates were closely related to the Ibe rian clone of MRSA, which is widely spread in Europe. The initial sour ce of I:E:F isolates was sputum 49%, blood 23%, wound 16%, urine 7%, a nd intravascular catheter tip 5%, Fifty-four percent of patients had s moke inhalation injury, and 51/53 required intubation or tracheostomy. Forty-three isolates were considered invasive (positive blood culture ). The overall mortality was 30%, Despite infection control measures, the I:E:F clone continued to be recovered from patients during the 18 months of study. This outbreak is the first known report of the Iberia n MRSA clone in the United States.