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Forschungsdatenbank PMU-SQQUID

Nosocomial Staphylococcal scalded skin syndrome caused by intra-articular injection.
Emberger, M; Koller, J; Laimer, M; Hell, M; Oender, K; Trost, A; Maass, M; Witte, W; Hintner, H; Lechner, AM;
J EUR ACAD DERMATOL. 2011; 25(2): 227-231.
Originalarbeiten (Zeitschrift)


Hell Markus
Hintner Helmut
Koller Josef
Laimer Martin
Önder Kamil
Zurl Andrea


Background The pathogenic role of nasal carriage as a source for cutaneous and soft-tissue Staphylococcus aureus (SA) infections, and Staphylococcal scalded skin syndrome (SSSS) in particular, is unclear. Observation We herein describe a nosocomial outbreak of SSSS in three orthopaedic patients who received intra-articular injections by a single orthopaedic surgeon. Bacteriological samples from the index patients and medical personnel involved in their care were assessed by phage typing, polymerase chain reaction for exfoliative toxin genes, SmaI macro-restriction analysis and molecular spa-typing. These studies first revealed SA cultural growth in synovial fluid of all three patients as well as nasal mucosa of one medical assistant. Moreover, all SA isolates had the same phage typing and antibiotic susceptibilities and were positive for exfoliative toxin ETa by polymerase chain reaction. SmaI macro-restriction and spa-typing further confirmed all proband isolates to be identical. Conclusion These findings provide evidence that SA nasal colonization of otherwise healthy carriers is a risk factor for SA infections, including SSSS, in predisposed individuals.

Useful keywords (using NLM MeSH Indexing)

Adrenal Cortex Hormones/administration*


Adrenal Cortex Hormones/therapeutic use


Anti-Bacterial Agents/therapeutic use

Cross Infection/diagnosis*

Cross Infection/drug therapy

Cross Infection/transmission*




Injections, Intra-Articular/adverse effects*


Nasal Mucosa/microbiology

Osteoarthritis/drug therapy

Risk Factors


Staphylococcal Scalded Skin Syndrome/diagnosis*

Staphylococcal Scalded Skin Syndrome/drug therapy

Staphylococcal Scalded Skin Syndrome/transmission*

Staphylococcus aureus/isolation*


Treatment Outcome

Find related publications in this database (Keywords)

intra-articular injection
Staphylococcal scalded skin syndrome
Staphylococcus aureus nasal carriage