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Methicillin-Resistant Staphylococcus aureus in Two Tertiary-Care Centers in Jeddah, Saudi Arabia

Published online by Cambridge University Press:  02 January 2015

Tariq A. Madani*
Affiliation:
Departments of Internal Medicine, Jeddah, Saudi Arabia King Abdulaz University Hospital, Jeddah, Saudi Arabia
Nabeela A. Al-Abdullah
Affiliation:
King Abdulaz University Hospital, Jeddah, Saudi Arabia
Ali A. Al-Sanousi
Affiliation:
Joint Program of Family and Community Medicine, Jeddah, Saudi Arabia
Tawfik M. Ghabrah
Affiliation:
Community Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
Shadia Z. Afandi
Affiliation:
King Fahd Hospital, Jeddah, Saudi Arabia
Huda A. Bajunid
Affiliation:
King Fahd Hospital, Jeddah, Saudi Arabia
*
Department of Internal Medicine, King Abdulaziz University Hospital, PO Box 80215, Jeddah 21589, Saudi Arabia

Abstract

Objective:

To review clinical experience with methicillin-resistant Staphylococcus aureus (MRSA) in tertiary-care hospitals in Jeddah, Saudi Arabia.

Design:

Retrospective review for the year 1998.

Setting:

Two tertiary-care hospitals.

Methods:

Results of MRSA-positive cultures of clinical specimens obtained as part of investigations for suspected infections were retrieved from the microbiology laboratories' records. Charts of patients were reviewed, with standardized data collection.

Results:

Of 673 S aureus isolates identified, 222 (33%, or 6.8 isolates/1,000 admissions) were MRSA Overall MRSA prevalence was 2% in 1988. Nosocomial acquisition occurred in 84.2% of cases. All age groups were affected, and 52% of patients had at least one comorbidity. MRSA prevalence was highest in the intensive care units (26.6% of all isolates), the medical wards (24.8%), and the surgical wards (19.8%). Seventy-three percent of isolates caused infection; the rest represented colonization. Surgical wounds (35.2%), the chest (29%), and central venous catheters (13%) were the most common sites of infection. Bacteremia occurred in 15.4% of patients. Local signs (84%) and fever (75.9%) were the most common clinical manifestations. Respiratory distress and septic shock occurred in 30.2% and 13.6% of cases, respectively. Of 162 patients with MRSA infection and 60 patients with MRSA colonization, 95.7% and 70% received antibiotics in the preceding 6 weeks, respectively (P<.0001). The total mortality of patients with MRSA infection was 53.7%: 36.4% as a result of MRSA infection and 17.3% as a result of other causes.

Conclusions:

The prevalence of MRSA is high and rapidly increasing in the two hospitals, as it is worldwide. Control measures to prevent die spread of MRSA in hospitals should continue, with reinforcement of hygienic precautions and development of policies to restrict the use of antibiotics.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2001

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