Methicillin-resistant Staphylococcus aureus in two tertiary-care centers in Jeddah, Saudi Arabia.
OBJECTIVE
To review clinical experience with methicillin-resistant Staphylococcus aureus (MRSA) in tertiary-care hospitals in Jeddah, Saudi Arabia.


METHODS
Retrospective review for the year 1998.


METHODS
Two tertiary-care hospitals.


METHODS
Results of MRSA-positive cultures of clinical specimens obtained as part of investigations for suspected infections were retrieved from the microbiology laboratories' records. Charts of patients were reviewed, with standardized data collection.


RESULTS
Of 673 S. aureus isolates identified, 222 (33%, or 6.8 isolates/1,000 admissions) were MRSA. Overall MRSA prevalence was 2% in 1988. Nosocomial acquisition occurred in 84.2% of cases. All age groups were affected, and 52% of patients had at least one comorbidity. MRSA prevalence was highest in the intensive care units (26.6% of all isolates), the medical wards (24.8%), and the surgical wards (19.8%). Seventy-three percent of isolates caused infection; the rest represented colonization. Surgical wounds (35.2%), the chest (29%), and central venous catheters (13%) were the most common sites of infection. Bacteremia occurred in 15.4% of patients. Local signs (84%) and fever (75.9%) were the most common clinical manifestations. Respiratory distress and septic shock occurred in 30.2% and 13.6% of cases, respectively. Of 162 patients with MRSA infection and 60 patients with MRSA colonization, 95.7% and 70% received antibiotics in the preceding 6 weeks, respectively (P<.0001). The total mortality of patients with MRSA infection was 53.7%: 36.4% as a result of MRSA infection and 17.3% as a result of other causes.


CONCLUSIONS
The prevalence of MRSA is high and rapidly increasing in the two hospitals, as it is worldwide. Control measures to prevent the spread of MRSA in hospitals should continue, with reinforcement of hygienic precautions and development of policies to restrict the use of antibiotics.
Madani
T A
TA
Department of Internal Medicine, King Abdulaziz University, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.
Al-Abdullah
N A
NA
Al-Sanousi
A A
AA
Ghabrah
T M
TM
Afandi
S Z
SZ
Bajunid
H A
HA
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission; D004781:Environmental Exposure / Q000032:analysis / Q000706:statistics & numerical data; D005260:Female; D006757:Hospital Units; D006784:Hospitals, Teaching; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D017053:Infection Control / Q000379:methods; D008297:Male; D016106:Methicillin Resistance; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012529:Saudi Arabia / Q000453:epidemiology; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000635:transmission; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification*