A national survey of antimicrobial resistance in Staphylococcus aureus in Australian teaching hospitals.
An extensive survey of the in-vitro susceptibility of clinical isolates of Staphylococcus aureus to 18 antimicrobial agents was conducted over three separate periods during 1986-1987 in 14 teaching hospitals in major Australian cities. The survey aimed to document the prevalence of resistance to a wide variety of drugs that are important as antistaphylococcal agents or as epidemiological markers. More than 7500 isolates were examined. Nationally, the prevalence of resistance was 85.3% to penicillin G, 14.4% to methicillin, 14.0% to amoxycillin/clavulanate, 9% to cephalothin, 5.4% to cephamandole, 9.9% to cefotaxime, 25.0% to erythromycin, 11.2% to clindamycin, 21.7% to tetracycline, 13.0% to gentamicin, 1.9% to amikacin, 5.8% to chloramphenicol, 18.3% to trimethoprim, 0.6% to rifampicin, 3.0% to fusidic acid and 1.2% to novobiocin. For none of the strains was resistance to vancomycin confirmed by minimal-inhibitory-concentration determination. A high proportion of the resistances was harboured in methicillin-resistant Staph. aureus, except for resistance to penicillin G, erythromycin and tetracycline. The prevalence of methicillin resistance varied widely among the states: 25.2% in Queensland, 23.5% in Victoria, 12.6% in New South Wales/the Australian Capital Territory, 11.3% in South Australia and 0.4% in Western Australia. Isolates from blood cultures were slightly-more susceptible to antimicrobial agents than were isolates from other body sites. Six common profiles of resistance to penicillin G, methicillin, erythromycin, clindamycin and tetracycline accounted for more than 95% of the isolates that were tested against all five agents. Vancomycin remains the most important antistaphylococcal drug in areas where resistance to methicillin is common.
Turnidge
J
J
Flinders Medical Centre, Bedford Park, SA.
Lawson
P
P
Munro
R
R
Benn
R
R
D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001315:Australia; D003428:Cross Infection / Q000382:microbiology; D003470:Culture Media; D004352:Drug Resistance, Microbial; D006784:Hospitals, Teaching; D006801:Humans; D008712:Methicillin / Q000494:pharmacology; D008826:Microbial Sensitivity Tests; D010403:Penicillin Resistance; D013203:Staphylococcal Infections; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000302:isolation & purification
D000900:Anti-Bacterial Agents; D003470:Culture Media; D008712:Methicillin