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A Longitudinal Analysis of Methicillin-Resistant Staphylococcus aureus in a Hong Kong Teaching Hospital

  • Margaret Ip (a1), D. J. Lyon (a1), F. Chio (a1) and A. F. Cheng (a1)

Abstract

Objectives:

To review the incidence and trends of MRSA during a 12-year (1989-2000) period at a university teaching hospital and the relationship between strain distribution by antibiogram and molecular typing.

Design:

Retrospective review of laboratory-based surveillance records on MRSA isolation and characterization of strains by antimicrobial susceptibility and PFGE. A patient episode was counted at the time when MRSA was first isolated.

Setting:

A 1,350-bed university teaching hospital in Hong Kong.

Patients:

Those with clinical isolates of MRSA.

Results:

During 1989 to 2000, the hospital recorded 1,203,175 deaths and discharges (D&D) and encountered 5,707 patient episodes of new MRSA isolation. The overall incidence of patient episodes of MRSA was 0.47/100 D&D. In 1989, the incidence was 0.81/100 D&D and fell to a low of 0.33/100 D&D in 1995, but then rose to 0.50/100 D&D in 2000. Antibiogram and DNA typing identified 5 major types. PFGE type A constituted 68% (211/312) of isolates and was present throughout the 12-year period. PFGE type B constituted 13% (40/312) of isolates and was only present from 1995 to 2000. These isolates form a distinct clone and had unique antibiotic resistance profiles.

Conclusions:

The study showed the establishment of a dominant MRSA clone (PFGE type A group) in the intensive care, medical, and surgical units and the appearance of a new MRSA strain in 1995 (PFGE type B), which partly explained the rise in incidence of MRSA cases and a disproportionate rise in MRSA bacteremia from 1995 to 2000.

Copyright

Corresponding author

Department of Microbiology, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong

References

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1.Bell, JM, Turnidge, JD, Sentry APAC participants. High prevalence of oxacillin-resistant Staphylococcus aureus isolates from hospitalized patients in Asia-Pacific and South Africa: results from SENTRY antimicrobial surveillance program, 1998-1999. Antimicrob Agents Chemother 2002;46:879881.
2.French, GL, Ling, J, Ling, T, Hui, YW. Susceptibility of Hong Kong isolates of methicillin-resistant Staphylococcus aureus to antimicrobial agents. J Antimicrob Chemother 1988;21:581588.
3.Lyon, DJ. Living with MRSA in an area of high prevalence. Presented at the First International Congress of the Asia Pacific Society of Infection Control; August 1999; Hong Kong. Abstract S9.
4.Adeyemi-Doro, FAB, Scheel, O, Lyon, DJ, Cheng, AFB. Living with methicillin-resistant Staphylococcus aureus: a 7-year experience with endemie MRSA in a university hospital. Infect Control Hosp Epidemiol 1997;18:765767.
5.Farrington, M, Ling, J, Ling, T, French, GL. Outbreaks of infection with methicillin-resistant Staphylococcus aureus on neonatal and burns units of a new hospital. Epidemiol Infect 1990;105:215228.
6.French, GL, Ling, J, Farrington, M. Typing of Staphylococcus aureus resistant to methicillin. BMJ 1986;293:14381439.
7.National Committee for Clinical Laboratory Standards. Performance Standards for Antimicrobial Susceptibility Testing. Wayne, PA: National Committee for Clinical Laboratory Standards; 2000.
8.Brown, DJF, Livermore, DM, Symonds, JM, Wise, R. Antimicrobial susceptibility testing: BSAC working party report. JAntimicrob Chemother 2002;48:1102.
9.Kaufmann, ME, Pitt, TL. Pulsed-field gel electrophoresis of bacterial DNA. In: Chart, H, ed. Methods in Practical Laboratory Bacteriology. Boca Raton, FL: CRC Press; 1994:8392.
10.Tenover, FC, Arbeit, RD, Goering, RV, et al.Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing. J Clin Microbiol 1995;33:22332239.
11.Cheng, AF, French, GL. Methicillin-resistant Staphylococcus aureus bacteremia in Hong Kong. J Hosp Infect 1988;12:91101.
12.Scheel, O, Lyon, DJ, Rosdahl, VT, Adeyemi-Doro, FAB, Ling, TKW, Cheng, AFB. Invitro susceptibility of isolates of methicillin-resistant Staphylococcus aureus 1988-1993. J Antimicrob Chemother 1996:37:243-251.
13.Vandenbroucke-Grauls, CM. Control of methicillin-resistant Staphylococcus aureus in the Netherlands. In: Coello, R, Casewell, MW, eds. Methicillin-Resistant Staphylococcus aureus. Kent, United Kingdom: Wells Medical Limited; 1993:7578.

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