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Drug-resistant coagulase-negative skin staphylococci: Evaluation of four marker systems and epidemiology in an orthopaedic ward

Published online by Cambridge University Press:  15 May 2009

M. Thore*
Affiliation:
Department of Clinical Bacteriology, County Hospital, Västerås
I. Kühn
Affiliation:
National Bacteriological Laboratory, Stockholm, Sweden
S. Löfdahl
Affiliation:
National Bacteriological Laboratory, Stockholm, Sweden
L. G. Burman
Affiliation:
National Bacteriological Laboratory, Stockholm, Sweden
*
* Magnus Thore. Department of Clinical Bacteriology, County Hospital, S-721 89 Västerås, Sweden.
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Drug-resistant coagulase-negative staphylococci (DRCNS) in orthopaedic patients and ward staff were studied. A significant increase in the DRCNS carriage rate was observed among the 16 patients studied after 14 days of hospitalization with levels approaching that of the staff. Patients receiving dicloxacillin prophylaxis (n=9) were more likely to be colonized with methicillin-resistant CNS, while patients receiving no antibiotics (n= 7) became to a larger extent colonized with multiple DRCNS. The combined data from species determination, biochemical, plasmid, and antibiogram typing revealed a considerable diversity among DRCNS;64 types were distinguished among 112 DRCNS isolates selected for study after exclusion of apparently duplicate isolates. Plasmid plus antibiogram typing yielded almost as many types (61); whereas species determination plus antibiogram distinguished only 33 types. Although a novel computerized 96-reaction boityping method alone enabled differentiation of 17 biotypes, most DRCNS isolates belonged to one of three major biotypes limiting the usefulness of this method. Ten of the 64 (16%) DRCNS types identified comprised 50 of the 112 (45%) isolates. These were isolated from staff and from patients on day 14, suggesting a nosocomial origin.

Type
Special Article
Copyright
Copyright © Cambridge University Press 1990

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