Journal Article

Successful Termination of a Furunculosis Outbreak Due to <i>lukS-lukF</i>–Positive, Methicillin-Susceptible <i>Staphylococcus aureus</i> in a German Village by Stringent Decolonization, 2002–2005

Miriam Wiese-Posselt, Dagmar Heuck, Andreas Draeger, Martin Mielke, Wolfgang Witte, Andrea Ammon and Osamah Hamouda

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 44, issue 11, pages e88-e95
Published in print June 2007 | ISSN: 1058-4838
Published online June 2007 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/517503
Successful Termination of a Furunculosis Outbreak Due to lukS-lukF–Positive, Methicillin-Susceptible Staphylococcus aureus in a German Village by Stringent Decolonization, 2002–2005

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Background. Skin infections due to Staphylococcus aureus have recently become a public concern, mainly because of emerging resistance against widely used antibiotics and specific virulence determinants. Strains harboring the lukS-lukF gene (which codes for Panton-Valentine leukocidin) are frequently associated with severe furunculosis. Generally applicable strategies for the control of community outbreaks of furunculosis have not been defined.

Methods. We report the investigation and successful termination of an outbreak of furunculosis due to lukS-lukF–positive S. aureus in a German village (n = 144). Nasal swab specimens were obtained from village residents. A retrospective cohort study was conducted. Nasally colonized persons, persons who had current furuncles or who had experienced relapsing furuncles since 2002, and their family members underwent stringent decolonization measures using mupirocin nasal ointment and disinfecting wash solution. Multiple nasal swab specimens were obtained to monitor the long-term outcome of decolonization measures.

Results. From January 1998 through December 2004, 42 cases and 59 relapses of furunculosis were identified by active case finding. Of 140 participants tested, 51 (36%) were found to be nasally colonized with S. aureus. In 9 participants, the strain was positive for lukS-lukF. No methicillin resistance was detected. Risk of furunculosis was associated with contact with case patients (relative risk, 6.8; 95% confidence interval, 3.2–14.3) and nasal colonization with a lukS-lukF–positive strain of S. aureus (relative risk, 3.6; 95% confidence interval, 2.3–5.9). Passive surveillance implemented in January 2005 did not detect any case of lukS-lukF–positive, S. aureus–associated furuncles in this village.

Conclusion. This report describes a successful strategy for terminating the transmission of epidemic strains of S. aureus among a nonhospitalized population.

Journal Article.  4353 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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