Prevalence of toxin producing strains of Staphylococcus aureus in a pediatric burns unit

The aims of the study were to determine the sites in a pediatric burns unit that were contaminated with Staphylococcus aureus. Samples from the environment in bedrooms and the common room were taken monthly for 6 months using blood agar for total counts and Baird-Parker agar for S. aureus. The air was sampled using an air-sampling device and settle plates. Hard and soft surfaces including bed, blanket, sofa, chair, taps, bathtub, soft toys, locker and cupboard in the same rooms were sampled using contact plates. Swabs were taken from staff monthly for 3 months. S. aureus isolates were tested for production of enterotoxins A–D and toxic shock syndrome toxin-1 using a reverse passive latex agglutination test. The results showed that S. aureus was recovered more frequently using settle plates than using the air sampler. All surfaces sampled were contaminated with S. aureus and contamination was greatest in frequently occupied rooms. A variety of toxin producing isolates were found with enterotoxin C isolates, either alone or in combination with TSST-1 (toxic shock syndrome toxin-1) dominant. The staff were transiently colonised with S. aureus strains with a different toxin production pattern. The results show that airborne transmission may be a route for infection by S. aureus and is responsible for contaminating the environment.