Send to

Choose Destination
Int J Infect Dis. 2009 Nov;13(6):e401-6. doi: 10.1016/j.ijid.2009.02.004. Epub 2009 Apr 22.

Panton-Valentine leukocidin-positive methicillin-resistant Staphylococcus aureus outbreak among healthcare workers in a long-term care facility.

Author information

Department for Interventions in Healthcare Facilities, Hellenic Center for Disease Control and Prevention, 42 3rd Septemvriou Street, Athens 10433, Greece.



We investigated an outbreak of community-acquired methicillin-resistant Staphylococcus aureus (MRSA) infections that occurred among healthcare workers (HCWs) but not among residents of a long-term care facility (LTCF).


Cases of S. aureus infection were sought by reviewing the medical records of residents and HCWs. In order to identify risk factors for the development of an S. aureus infection, an unmatched case-control study was conducted. Cases were all HCWs with a clinically compatible S. aureus infection; controls were HCWs with no history of a clinically compatible S. aureus infection. Cases and controls were interviewed and anterior nasal swabs were collected.


Over a period of 14 months, a total of eight cases were identified among practice nurses, giving an attack rate of 10% for this category of profession. All isolates were identified as MRSA Panton-Valentine leukocidin (PVL)-producing SCCmec type IV. By multivariate analysis, working in a specific zone and being a practice nurse were found to be statistically significant risk factors for infection.


The current outbreak indicates that HCWs may serve as vehicles for the entry of PVL-positive MRSA strains from the community into LTCFs, and that deficient hygiene practices and unrecognized carriage may facilitate spread. Given the increasing prevalence of PVL-positive MRSA infections worldwide, guidelines for the eradication of PVL-positive MRSA carriage within closed communities should be established and efforts to obtain cultures from compatible infections should be made.

[Indexed for MEDLINE]
Free full text

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center