Rapid spread of methicillin-resistant Staphylococcus aureus in a new hospital in the broad-spectrum antibiotic era.
OBJECTIVE
It has been known that it takes a long time for methicillin-resistant Staphylococcus aureus (MRSA) to introduce and become endemic within a hospital. During the last decade, widespread use of broad-spectrum antibiotics might have affected the time required for MRSA to spread and become endemic in hospitals. However, there has been no report on this issue. We investigated how fast MRSA has spread and become endemic in a hospital opened in the broad-spectrum antibiotic era.


METHODS
The study was performed at a Korean hospital, which opened in 1999. We examined the change of antimicrobial susceptibility and antimicrobial use density (AUD) for 6 years since hospital opening.


RESULTS
S. aureus susceptibility to oxacillin decreased from 64% in the first month to 33% in the second month (P=.05), and then has maintained around 30%. AUD was remarkably high from the first year, in which total AUD and those of aminopenicillins, second-generation cephalosporins, fluoroquinolones, and macrolides were 4674.6, 1444.6, 1700.9, 421.3, and 520.0 DDD/1000 patient-days, respectively.


CONCLUSIONS
MRSA has spread within a few months in a hospital opened in the broad-spectrum antibiotic era. Excessively high use of broad-spectrum antibiotics seems to be responsible for rapid spread of MRSA in the hospital.
Lee
S S
SS
Division of Infectious Diseases, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, 896 Pyeongchon-dong, Dongan-gu, Anyang-si, Gyeonggi-do 431-070, South Korea.
Kim
H S
HS
Kang
H J
HJ
Kim
J K
JK
Chung
D R
DR
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology; D019353:Endemic Diseases; D006761:Hospitals; D006801:Humans; D007723:Korea; D016106:Methicillin Resistance; D008826:Microbial Sensitivity Tests; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology*; D013211:Staphylococcus aureus / Q000302:isolation & purification*; D013997:Time Factors
D000900:Anti-Bacterial Agents