title: [A study of resistance to antiseptics of methicillin resistant Staphylococcus aureus (MRSA) in gastroenterological surgery].
abstract: Highly methicillin-resistant Staphylococcus aureus (H-MRSA, MIC greater than 100 micrograms/ml) was prevalent from 1986 in our institution. The failure of povidone-iodine to reduce the prevalence of MRSA led us to choose chlorhexidine-ethanol solution as an antiseptic, and then the isolation frequency of H-MRSA decreased significantly in 1988. When H-MRSA began to increase again recently, we studied the resistance to antiseptics of MRSA in order to investigate the cause of this re-increase. Common antiseptics were tested against 45 strains of H-MRSA and 22 strains of methicillin sensitive S. aureus (MSSA, MIC less than 12.5 micrograms/ml). Dilute preparations (1:100) of povidone-iodine and chlorhexidine-ethanol solution were more effective on H-MRSA than the other antiseptics. Though there was no significant difference between H-MRSA and MSSA in their sensitivity to povidone-iodine, the killing of H-MRSA strains was more delayed than the killing of MSSA strains in chlorhexidine. Even after a 120-second exposure, 13.3% of H-MRSA strains were resistant to chlorhexidine (more than 1000 colonies were recovered). These highly chlorhexidine-resistant strains have been isolated since 1987 when we chose chlorhexidine-ethanol solution as the antiseptic in our institution. Therefore we suspect that the acquirement of resistance to antiseptics by H-MRSA caused the re-increase of this strain.
authors.affiliation: First Department of Surgery, Hiroshima University School of Medicine, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Takesue
authors.forename: T
authors.initials: T
authors.lastname: Yokoyama
authors.forename: T
authors.initials: T
authors.lastname: Kodama
authors.forename: Y
authors.initials: Y
authors.lastname: Imamura
authors.forename: Y
authors.initials: Y
authors.lastname: Murakami
authors.forename: H
authors.initials: H
authors.lastname: Sewake
authors.forename: Y
authors.initials: Y
authors.lastname: Matsuura
mesh_terms: D000891:Anti-Infective Agents, Local / Q000494:pharmacology*; D002710:Chlorhexidine / Q000494:pharmacology; D004352:Drug Resistance, Microbial; D000431:Ethanol / Q000494:pharmacology; D005767:Gastrointestinal Diseases / Q000382:microbiology* / Q000601:surgery; D006801:Humans; D016106:Methicillin Resistance; D011206:Povidone-Iodine / Q000494:pharmacology; D013211:Staphylococcus aureus / Q000187:drug effects*
chemical_list: D000891:Anti-Infective Agents, Local; D000431:Ethanol; D011206:Povidone-Iodine; D002710:Chlorhexidine