An outbreak of methicillin-resistant Staphylococcus aureus (M.R.S.A.) in a burn unit.

An outbreak of methicillin-resistant Staphyllococcus aureus (MRSA) in the burn unit of Siriraj Hospital from August 1990 to July 1991 was reported. Temporary decrease in the incidence of MRSA was observed during a period when no new cases were admitted. The incidence rose again after normal service resumed. Surveillance cultures in 29 patients from May to July 1991 grew MRSA in 19 patients (65.5 per cent). Infection by MRSA was found in 14 patients (48.3 per cent). Methicillin-resistant Staphylococcus aureus first appeared in these patients mainly during the first and second weeks of admission. Wound infections were the only manifestation in 14 patients. Four of the MRSA infected patients died of infection by organisms other than MRSA. Nasal carriage was found in 2 of 25 ward staff members. The cost of treatment for each episode of MRSA infection was as high as 19,322.90 baht. The epidemic of MRSA infections persisted despite all control measures resulting in temporary closure of the ward.