Update on non-MRSA PVL cases

Microbiologists, infection control and paediatric staff at the Norfolk and Norwich University Hospital have been working through the Christmas break to continue screening babies and parents for non-MRSA Panton-Valentine Leukocidin (PVL) positive S aureus.

As announced on Friday December 22, a baby boy who was born at 26 weeks died on December 11 and laboratory tests have since confirmed that he had a PVL infection. Five babies were also found to be carrying the bug.  All have responded well to antibiotic treatment.

A parent of one of the five babies has since tested positive for this  rare PVL strain of Staphlyococcus aureus (S. aureus) and screening has also revealed that a seventh baby is also carrying the bug. The baby boy had previously returned home but was swabbed following an appeal to parents whose babies had been treated in the neonatal unit between 22 November and 19 December.

Consultant microbiologist Dr Judith Richards commented: “We are doing all we can to ensure that all babies who have been treated on the unit between 22 November and 19 December are screened, along with close relatives and all neonatal staff, so that appropriate treatment can be given.

“Testing has continued throughout the Christmas period and many of our staff have worked extra hours to help deal with the outbreak. In addition to caring for 26 babies on the neonatal unit, the staff have also been available to talk to parents and answer their questions.

“We would stress that none of the babies affected are actively infected with the PVL toxin. Also, none of the staff who have been swabbed so far have been found to be carrying the bug.”

A total of 63 sets of parents are being contacted to request that they return to the hospital with their babies to be screened. This involves taking a swab from the nose and throat which is then tested in the hospital laboratory. If necessary, they will be decolonised at home, and treated with appropriate antibiotics.

The unit has undergone additional specialist cleaning and has been closed to new admissions from other hospitals. Visiting on the unit is also being restricted to parents only.

Further testing is taking place this week to ensure that all babies on the neonatal unit, along with close relatives and staff, are clear of the PVL strain of Staphlyococcus aureus.

The cluster of PVL cases is the first to be seen in the 28-cot neonatal unit at the Norfolk and Norwich University Hospital. The particular infection is a rare strain of Staphlyococcus aureus (S. aureus) which is not the same MRSA-related strain that has been seen recently in the West Midlands.

Panton-Valentine Leukocidin (PVL)-positive S aureus has been seen in the UK before a small number of cases reported,  usually  in the community rather than a hospital setting. It can be treated with antibiotics.

The infections are caused by strains of S. aureus which carry a toxin (PVL) that destroys white blood cells. The toxin is carried by less than two per cent of S. aureus.

The PVL strains affect previously healthy young children and young adults – in contrast to the so-called “hospital-associated MRSA” strains which do not produce PVL and are more commonly associated with causing wound infections and blood-poisoning in more elderly hospitalised.

Wednesday 27th of December 2006 10:00:27 AM