INTRODUCTION: The purpose of this study was to describe a nosocomial outbreak caused by @entity3256 resistant @entity23819 (MRSP) @entity27397 SCCmec II-III in @entity235 and @entity468 at the Veterinary Teaching Hospital of the University of Helsinki in November 2010 - January 2012, and to determine the risk factors for acquiring MRSP. In addition, measures to control the outbreak and current policy for MRSP prevention are presented. METHODS: Data of @entity1 were collected from the hospital @entity1 record software. MRSP surveillance data were acquired from the laboratory information system. Risk factors for MRSP acquisition were analyzed from 55 cases and 213 controls using multivariable logistic regression in a case-control study design. Forty-seven MRSP isolates were analyzed by pulsed field gel electrophoresis and three were further analyzed with multi-locus sequence and SCCmec typing. RESULTS: Sixty-three MRSP cases were identified, including 27 @entity281 . MRSPs from the cases shared a specific multi-drug resistant antibiogram and @entity20297 -pattern indicated clonal spread. Four risk factors were identified; @entity272 (OR=6.2; CI95% 2.3-17.0, P=0.0003), antimicrobial treatment (OR=3.8, CI95% 1.0-13.9, P=0.0442), cumulative number of days in the intensive care unit (OR=1.3, CI95% 1.1-1.6, P=0.0007) or in the surgery ward (OR=1.1, CI95% 1.0-1.3, P=0.0401). Tracing and screening of contact @entity1 , enhanced hand hygiene, cohorting and barrier nursing, as well as cleaning and disinfection were used to control the outbreak. To avoid future outbreaks and spread of MRSP a search-and-isolate policy was implemented. Currently nearly all new MRSP findings are detected in screening targeted to risk @entity1 on admission. CONCLUSION: Multidrug resistant MRSP is capable of causing a large outbreak difficult to control. @entity272 , antimicrobial treatment and prolonged hospital stay increase the probability of acquiring MRSP. Rigorous control measures were needed to control the outbreak. We recommend the implementation of a search-and-isolate policy to reduce the burden of MRSP.

Large Outbreak Caused by @entity3256 Resistant XXXX @entity27397 in a Finnish Veterinary Teaching Hospital - From Outbreak Control to Outbreak Prevention.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity3256 :: ('MESH:D008712', 'Chemical') :: ['methicillin'] @entity235 :: ('9615', 'Species') :: ['dogs'] @entity20297 :: ('25870', 'Gene') :: ['PFGE'] @entity468 :: ('9685', 'Species') :: ['cats'] @entity281 :: ('MESH:D007239', 'Disease') :: ['infections'] @entity23819 :: ('283734', 'Species') :: ['Staphylococcus pseudintermedius'] @entity272 :: ('MESH:D012871', 'Disease') :: ['Skin lesions', 'skin lesion'] @entity27397 :: ('MESH:C034490', 'Chemical') :: ['ST71']
@entity23819 :: (283734,Species) :: ['Staphylococcus pseudintermedius']
