title: Increased resistance among Staphylococcus epidermidis isolates in a large teaching hospital over a 12-year period.
abstract: The prevalence of drug resistance among clinically significant blood isolates of Staphylococcus epidermidis (n = 464) and consumption of antibiotics at a tertiary care teaching hospital (Meilahti Hospital, Helsinki) were analysed for the period 1983-1994. Resistance to methicillin increased from 28 to 77%. Simultaneously, usage of third-generation cephalosporins increased nearly sevenfold (from 8.6 kg/ to 56.4 kg/year). A significant correlation was found between percentages of methicillin resistance and usage of penicillinase-stable beta-lactam agents, including cloxacillin, imipenem, and first-, second-, and third-generation cephalosporins (r = 0.737, p < 0.0062). The increase in ciprofloxacin resistance occurred soon after the introduction of ciprofloxacin. Moreover, there was a remarkable increase in resistance to fusidic acid (from 10 to 40%) and rifampin (from 0 to 23%) despite the low usage of these agents. Overall, the rate of multiply resistant isolates roughly tripled (from 20 to 71%) and, by 1994, the frequency of isolates susceptible to vancomycin only was as high as 11%, which remarkably limits options for therapy.
authors.affiliation: Department of Medicine, Helsinki University Central Hospital, Finland.
authors.forename: O
authors.initials: O
authors.lastname: Lyytikäinen
authors.forename: M
authors.initials: M
authors.lastname: Vaara
authors.forename: E
authors.initials: E
authors.lastname: Järviluoma
authors.forename: K
authors.initials: K
authors.lastname: Rosenqvist
authors.forename: L
authors.initials: L
authors.lastname: Tiittanen
authors.forename: V
authors.initials: V
authors.lastname: Valtonen
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D003428:Cross Infection / Q000188:drug therapy* / Q000382:microbiology; D004352:Drug Resistance, Microbial; D018432:Drug Resistance, Multiple; D004363:Drug Utilization; D005387:Finland; D006784:Hospitals, Teaching; D006801:Humans; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000188:drug therapy*; D013212:Staphylococcus epidermidis / Q000187:drug effects*
chemical_list: D000900:Anti-Bacterial Agents