Risk factors and associated problems in the management of infections with methicillin resistant Staphylococcus aureus.
OBJECTIVE
It is necessary to define the problem of methicillin resistant Staphylococcus aureus (MRSA) in every hospital to evolve control strategies. The objectives of this study were to determine factors influencing the persistence of MRSA in patients with hospital acquired infection and to identify alternate cost effective antibiotics.


METHODS
A six month study was carried out for 50 patients with MRSA infection. Treatment modalities and risk factors were determined by a preset protocol. Minimum inhibitory concentration of commonly used antibiotics was determined.


RESULTS
The risk factors were prolonged postoperative morbidity, prior antibiotic therapy and emergency admissions. Seventy percent of the isolates were from postoperative cases undergoing emergency surgeries. Isolation was highest during the second week of hospital stay. Emergency admissions had a significantly higher chance of early isolation. Prior treatment with multiple antibiotics in 38% was found to be another major risk factor. Ofloxacin was seen to be efficacious in a small percentage of cases. Rifampicin in combination with ofloxacin and clindamycin were found to be other good alternatives. Ofloxacin was found to be the cheapest and vancomycin the most expensive, for a full course of treatment.


CONCLUSIONS
Minimizing risk factors and attention to alternate cost effective combination therapy may ease the problem of management of infections with MRSA.
Srinivasan
S
S
Department of Clinical Microbiology, Pondicherry Institute of Medical Sciences, Pondicherry - 605 014, India.
Sheela
D
D
Mathew
R
R
Bazroy
J
J
Kanungo
R
R
D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D024881:Drug Resistance, Bacterial; D004359:Drug Therapy, Combination; D006801:Humans; D016106:Methicillin Resistance; D008826:Microbial Sensitivity Tests; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000302:isolation & purification
D000900:Anti-Bacterial Agents