[Clinicopathological study of methicillin-resistant Staphylococcus aureus detected by pulmonary microbial culture in autopsied cases].
Microbial culture of lung specimens from 569 autopsied cases from 1986 to 1989 revealed methicillin-resistant Staphylococcus aureus (MRSA) in 28 cases, which were subsequently analyzed clinicopathologically. The number of MRSA positive cases has markedly increased in recent years (2 cases in 1986, 2 in 1987, 6 in 1988, 18 in 1989). The most frequent underlying disease was neoplasm, which was seen in 17 cases. Of non-neoplastic diseases, liver cirrhosis and diffuse panbronchiolitis were prevalent. Twenty-four cases had received a course of antibiotic therapy. Antibiotics frequently administered were third-generation Cephem and Imipenem/cilastatin sodium (used in 20 cases). Antibiotics o which MRSA was sensitive were administered in only one case (minocycline). Sputum culture was performed in only 10 cases, 5 of which were MRSA positive. MRSA had acquired resistance to fosfomycin and ofloxacin. Histological examination revealed complication by pneumonia in 19 cases. In 7 of these 19 cases, MRSA was the only pathogen detected. Pulmonary MRSA infection detected at autopsy is frequently seen in patients with terminal stage cancer, but it is frequently not diagnosed and is undertreated. This may be a factor responsible for the recent marked increase in the proportion of MRSA in pathogens causing infection within medical institutions.
Nambu
Y
Y
Department of Respiratory Medicine, Tenri Hospital, Nara, Japan.
Iwata
T
T
Oida
K
K
Kohri
Y
Y
Taguchi
Y
Y
Tomii
K
K
Mino
M
M
Ichijima
K
K
Kobashi
Y
Y
Aihara
M
M
D003428:Cross Infection / Q000382:microbiology* / Q000473:pathology; D006801:Humans; D008168:Lung / Q000382:microbiology*; D016106:Methicillin Resistance; D011023:Pneumonia, Staphylococcal / Q000382:microbiology* / Q000473:pathology; D012189:Retrospective Studies; D013211:Staphylococcus aureus / Q000302:isolation & purification*