Hostname: page-component-848d4c4894-x24gv Total loading time: 0 Render date: 2024-05-15T01:09:32.229Z Has data issue: false hasContentIssue false
  • English
  • Français

Clinical and Laboratory Studies of Nosocomial Staphylococcus aureus Resistant to Methicillin and Aminoglycosides

Published online by Cambridge University Press:  02 January 2015

Bonnie V. Bock ,
Karen Pasiecznik  and
Richard D. Meyer
Bonnie V. Bock
Affiliation:
Infectious Disease Section, Research and Medical Services, Veterans Administration, Wadsworth Hospital Center and the Department of Medicine, UCLA School of Medicine, Los Angeles, California
Karen Pasiecznik
Affiliation:
Infectious Disease Section, Research and Medical Services, Veterans Administration, Wadsworth Hospital Center and the Department of Medicine, UCLA School of Medicine, Los Angeles, California
Richard D. Meyer*
Affiliation:
Infectious Disease Section, Research and Medical Services, Veterans Administration, Wadsworth Hospital Center and the Department of Medicine, UCLA School of Medicine, Los Angeles, California
*
Infectious Disease Section (691/111F) Bldg. 500, Room 3658, Wadsworth V.A. Medical Center, Los Angeles, California 90073
Get access Rights & Permissions [Opens in a new window]

Abstract

A methicillin/aminoglycoside-resistant strain of Staphylococcus aureus (MARS) was likely introduced by transfer of a patient from another hospital. Over the next year, 20 other patients were colonized or infected with MARS of the same phage type, although antibiograms varied. Affected patients usually had serious underlying disease and were in intensive care units. Vancomycin therapy was frequently delayed and MARS may have contributed to the death of some patients. The mode of spread was not definitively delineated, but two nurses were found to be colonized. Institution of isolation procedures was difficult, but the problem gradually waned.

Susceptibility testing showed vancomycin to be the most active agent. Synergy studies showed no consistent effect of combining methicillin with an aminoglycoside. This experience illustrates the problem of MARS spread between hospitals and wards, the need for institution of effective control measures, and consideration of early empiric use of vancomycin.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 3 , Issue 3 , June 1982 , pp. 224 - 229
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1982

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Barber, M. Methicillin-resistant staphylococci. J Clin Path 1961;14:385–393.CrossRefGoogle ScholarPubMed
2. Knox, R, Smith, JT. The nature of penicillin resistance in staphylococci. Lancet 1961,1:520–522.CrossRefGoogle Scholar
3. Kayser, FH. Methicillin-resistant staphylococci. 1965-75. Lancet 1975;2:650–653.CrossRefGoogle ScholarPubMed
4. Benner, EJ, Morthland, V. Methicillin-resistant Staphylococcus aureus . N Engl J Med 1967;277(13):678–680.CrossRefGoogle ScholarPubMed
5. Barrett, FF, McGehee, RF, Finland, M. Methicillin-resistant Staphylococcus aureus at Boston City Hospital. N Engl J Med 1968;279(9):441–448.CrossRefGoogle ScholarPubMed
6. Schaefler, S, Perry, W, Jones, D. Methicillin-resistant strains of Staphylococcus aureus phagetype 92. Antimicrob Agents Chemother 1979;15(1):74–80.CrossRefGoogle Scholar
7. Klimek, JJ, et al. Clinical epidemiologic and bacteriologie observations of an outbreak of methicillin-resistant Staphylococcus aureus at a large hospital. Amer J Med 1976;61(3):340–345.CrossRefGoogle Scholar
8. Centers for Disease Control. Methicillin-resistant Staphylococcus aureus — United States. Morbid Mortal Week Rep 1981;30(12):140–147.Google Scholar
9. Centers for Disease Control. Community-acquired methicillin-resistant Staphylococcus aureus infections—Michigan. Morbid Mortal Week Rep 1981;30(16):185–187.Google Scholar
10. Porthouse, A. Gentamicin resistance in Staphylococcus aureus . Lancet 1976,1:20–21.CrossRefGoogle ScholarPubMed
11. Speller, DCE, et al. Epidemic infection by a gentamicin-resistant Staphylococcus aureus in three hospitals. Lancet 1976;1:464–466.CrossRefGoogle ScholarPubMed
12. Warren, RE, Roberts, SOB. Gentamicin-resistant staphylococci. (Letter) Lancet 1976;1:543–544.CrossRefGoogle ScholarPubMed
13. Buckwold, FJ, et al. Investigations of the occurrence of gentamicin-resistant Staphylococcus aureus . Antimicrob Agents Chemother 1979;15(2):152–156.CrossRefGoogle ScholarPubMed
14. Vogel, L, et al. Infections due to gentamicin-resistant Staphylococcus aureus strain in a nursery for neonatal infants. Antimicrob Agents Chemother 1978;13(3):466–472.CrossRefGoogle Scholar
15. Faden, H et al. Gentamicin-resistant Staphylococcus aureus. Emergence in an intensive care nursery. JAMA 1979;241(2):143–145.CrossRefGoogle Scholar
16. Greenhood, GP, Hill, DL, Dixon, RE. Changing phage typing patterns of epidemic gentamicin-resistant Staphylococcus aureus. Evidence for transmission of gentamicin resistance. Lancet 1979;1:289–291.CrossRefGoogle ScholarPubMed
17. Watanakunakorn, C, Glotzbecker, C. Enhancement of the effects of anti-staphylococcal antibiotics by aminoglycosides. Antimicrob Agents Chemother 1974;6(6):802–806.CrossRefGoogle Scholar
18. Miller, M, Wexler, M, Steigbigel, NH. Single and combination antibiotic therapy of Staphylococcus aureus experimental endocarditis: Emergence of gentamicin-resistant mutants. Antimicrob Agents Chemother 1978;14(3):336–343.CrossRefGoogle ScholarPubMed
19. Hemmer, RJP, Vandanx, P, Waldvogel, FA. Methicillin potentiates the effect of gentamicin on methicillin-resistant Staphylococcus aureus . Antimicrob Agents Chemother 1979;15(1):34–41.CrossRefGoogle ScholarPubMed
20. Shanson, DC, Kensit, JG, Duke, R. Outbreak of hospital infection with a strain of Staphylococcus aureus resistant to gentamicin and methicillin. Lancet 1976;2:1347–1348.CrossRefGoogle ScholarPubMed
21. Crossley, K, et al. An outbreak of infections caused by strains of Staphylococcus aureus resistant to methicillin and aminoglycosides. I. Clinical studies. J Infect Dis 1979;139(3):273–279.CrossRefGoogle ScholarPubMed
22. Crossley, K, Landesman, B, Zaske, D. An outbreak of infections caused by Staphylococcus aureus resistant to methicillin and aminoglycosides. II. Epidemiologic studies. J Infect Dis 1979;139:280–287.CrossRefGoogle ScholarPubMed
23. Peacock, JE, Marsik, FJ, Wenzel, RP. Methicillin-resistant Staphylococcus aureus: Introduction and spread within a hospital. Ann Intern Med 1980;93(4):526–532.CrossRefGoogle ScholarPubMed
24. Saraglou, G, Cromer, M, Bisno, Al. Methicillin-resistant Staphylococcus aureus: Interstate spread of nosocomial infections with emergence of gentamicin-methicillin resistant strain. Infection Control 1980;1(2):81–89.CrossRefGoogle Scholar
25. Price, EH, Brain, A, Dickson, JAS. An outbreak of infection with gentamicin and methicillin-resistant Staphylococcus aureus in a neonatal unit. Journal of Hospital Infection 1980;1(3):221–228.CrossRefGoogle Scholar
26. Bauer, AW, et al. Antibiotic susceptibility by a standardized single disc method. Am J Clin Path 1966;44(4):493–496.CrossRefGoogle Scholar
27. Ericsson, HM, Sherris, JC. Antibiotics sensitivity testing: Report of an international collaborative study. Acta Pathol Microbiol Scand [B] 1971;217:65–68 (Suppl).Google ScholarPubMed
28. Weinstein, RJ, Young, LS, Hewitt, WL. Comparison of methods for assessing in vitro antibiotic synergism against Pseudomonas and Serratia . J Clin Lab Med 1975;86(5):853–862.Google ScholarPubMed
29. Fu, KP, Neu, HC. In vitro synergistic effect of netilmicin, a new aminoglycoside antibiotic. Antimicrob Agents Chemother 1976;10(3):511–518.CrossRefGoogle ScholarPubMed
30. Schaefler, S, et al. Emergence of gentamicin-and methicillin-resistant Staphylococcus aureus strains in New York Hospitals. J Clin Microbiol 1981;13(4):754–759.CrossRefGoogle Scholar
31. Acar, JF, Courvalin, P, Chalbert, YA. Methicillin-resistant staphylococcemia: Bacteriologie failure of treatment with cephalosporins. In: Antimicrobial Agents Chemotherapy— 1970. Washington, D.C.: American Society for Microbiology, 1971, pp 280–285.Google Scholar
32. Siebert, WT, Moreland, N, Williams, TW Jr. Synergy of vancomycin plus cefazolin or cephalothin against methicillin-resistant Staphylococcus epidermidis . J Infect Dis 1979;139(4):452–457.CrossRefGoogle ScholarPubMed
33. McGowan, JE Jr, et al. Nosocomial infections with gentamicin-resistant Staphylococus aureus: Plasmid analysis as an epidemiologic tool. J Infect Dis 1979;140(6):864–872.CrossRefGoogle Scholar
34. Weinstein, RA, et al. Endemic aminoglycoside resistance in gram-negative bacilli. J Infect Dis 1980;141(3):338–345.CrossRefGoogle ScholarPubMed