Abstract:
Background: An eight (8) months prospective study
was carried out
to control an outbreak of nosocomial
pneumonia due to a Panton-Valentine Leukocidin
(PVL) producing Staphylococcus aureus, in the paediatrics’
unit at the Zou/Collines Departmental Hospital
(CHDZ/C), (Benin).
Methods: Between 1st September 2004 and 30th May
2005 an investigation was conducted that involved the
screening of all patients suspected to have nosocomial
pneumonia, hospital environment sampling and the
follow-up of cases until the end of hospital admission
period. Isolates were identified, tested for antimicrobial
susceptibility and analysed for PVL production. The
study period was divided into Period I, corresponding
to the outbreak period and Period II, after the complete
renovation of the Unit along with hand washing promotion.
Results: A total of 453 patients were admitted during
the period of the study; (235 during Period I and 218
during Period II) in the malnourished children sector.
Twenty eight (28) cases of pneumonia due to S. aureus
were discovered and PVL-producing S. aureus constituted
61% (17/28) of identified cases. The mortality
rate among the PVL- producing strains was 15/17
(88%) while it was 1/11 (9%) among non PVLproducing
strains. Enhanced hygiene measures helped
to terminate the outbreak.
Conclusions: This study showed that PVL was strongly
linked to nosocomial pneumonia. PVL-producing S
aureus can be controlled in the hospital by a combination
of the promotion of preventive measures, decontamination
of the environment and the early use of the
correct antibiotic at the appropriate dose and for an
adequate duration.