Methicillin-resistant Staphylococcus aureus: introduction and spread within a hospital.
In March 1978, a strain of methicillin-resistant Staphylococcus aureus was introduced from the community into a university hospital. Within 6 months of admission of the index case, methicillin-resistant S. aureus was isolated from 30 additional patients, 22 of whom were epidemiologically linked by a common phage type (6/47/54/75/83A) and roommate-to-roommate spread. Sixteen of 31 cases were infected, six with bacteremia. Patients with infections received cephalosporins more frequently before infection than did control subjects (p < 0.05). Patients acquiring methicillin-resistant S. aureus in the intensive care unit had a longer mean stay, had higher overall mortality, and received nafcillin and aminoglycosides more frequently than did cohorted control subjects. By mid-1979, methicillin-resistant S. aureus accounted for 38%, 31%, and 24% of all nosocomial S. aureus postoperative wound, pulmonary, and bloodstream infections, respectively. In hospitals with significant methicillin-resistant S. aureus isolation rates, initial empiric therapy of presumed S. aureus infection with vancomycin seems warranted.
D000328:Adult; D003428:Cross Infection / Q000453:epidemiology / Q000635:transmission*; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008712:Methicillin / Q000494:pharmacology*; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010403:Penicillin Resistance; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000635:transmission*; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000302:isolation & purification; D014768:Virginia
D008712:Methicillin