Increased Resistance Among Staphylococcus Epidermidis Isolates in a Large Teaching Hospital over a 12-year Period

Overview

Journal Eur J Clin Microbiol Infect Dis

Publisher Springer

Specialties Infectious Diseases
Microbiology

Date 1996 Feb 1

PMID 8801085

Citations 6

Authors

O Lyytikainen

M Vaara

E Jarviluoma

K Rosenqvist

L Tiittanen

V Valtonen

Affiliations

Soon will be listed here.

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.

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References

Schaberg D, Culver D, Gaynes R . Major trends in the microbial etiology of nosocomial infection. Am J Med. 1991; 91(3B):72S-75S. DOI: 10.1016/0002-9343(91)90346-y. View

Schwalbe R, Ritz W, Verma P, Barranco E, Gilligan P . Selection for vancomycin resistance in clinical isolates of Staphylococcus haemolyticus. J Infect Dis. 1990; 161(1):45-51. DOI: 10.1093/infdis/161.1.45. View

Pfaller M, Herwaldt L . Laboratory, clinical, and epidemiological aspects of coagulase-negative staphylococci. Clin Microbiol Rev. 1988; 1(3):281-99. PMC: 358051. DOI: 10.1128/CMR.1.3.281. View

Ena J, Dick R, Jones R, Wenzel R . The epidemiology of intravenous vancomycin usage in a university hospital. A 10-year study. JAMA. 1993; 269(5):598-602. View

SWARTZ M . Hospital-acquired infections: diseases with increasingly limited therapies. Proc Natl Acad Sci U S A. 1994; 91(7):2420-7. PMC: 43382. DOI: 10.1073/pnas.91.7.2420. View

Kernodle D, Barg N, Kaiser A . Low-level colonization of hospitalized patients with methicillin-resistant coagulase-negative staphylococci and emergence of the organisms during surgical antimicrobial prophylaxis. Antimicrob Agents Chemother. 1988; 32(2):202-8. PMC: 172135. DOI: 10.1128/AAC.32.2.202. View

Etienne J, Brun Y, Billard M, Fleurette J . Hospital dispersion of Staphylococcus epidermidis isolates resistant to a fluoroquinolone, pefloxacin. Epidemiol Infect. 1989; 103(3):459-64. PMC: 2249541. DOI: 10.1017/s0950268800030867. View

Neu H . The crisis in antibiotic resistance. Science. 1992; 257(5073):1064-73. DOI: 10.1126/science.257.5073.1064. View

Tripodi M, Attanasio V, Adinolfi L, Florio A, Cione P, Cuccurullo S . Prevalence of antibiotic resistance among clinical isolates of methicillin-resistant staphylococci. Eur J Clin Microbiol Infect Dis. 1994; 13(2):148-52. DOI: 10.1007/BF01982189. View

10.

Kotilainen P, Nikoskelainen J, Huovinen P . Emergence of ciprofloxacin-resistant coagulase-negative staphylococcal skin flora in immunocompromised patients receiving ciprofloxacin. J Infect Dis. 1990; 161(1):41-4. DOI: 10.1093/infdis/161.1.41. View

11.

Tullus K, Burman L . Ecological impact of ampicillin and cefuroxime in neonatal units. Lancet. 1989; 1(8652):1405-7. DOI: 10.1016/s0140-6736(89)90122-0. View

12.

Nystrom B, Ransjo U, Ringertz S, Faxelius G, Tunell R, Ohman G . Colonization with coagulase-negative staphylococci in two neonatal units. J Hosp Infect. 1992; 22(4):287-98. DOI: 10.1016/0195-6701(92)90014-d. View

13.

Banerjee S, Emori T, Culver D, Gaynes R, Jarvis W, Horan T . Secular trends in nosocomial primary bloodstream infections in the United States, 1980-1989. National Nosocomial Infections Surveillance System. Am J Med. 1991; 91(3B):86S-89S. DOI: 10.1016/0002-9343(91)90349-3. View

14.

Moller J . Observations on multiple drug resistance in coagulase-negative staphylococci isolated in hospitals from 1975 to 1985. J Hosp Infect. 1988; 11(1):26-35. DOI: 10.1016/0195-6701(88)90036-9. View

15.

Rupp M, Archer G . Coagulase-negative staphylococci: pathogens associated with medical progress. Clin Infect Dis. 1994; 19(2):231-43; quiz 244-5. DOI: 10.1093/clinids/19.2.231. View

16.

Tullus K, Berglund B, Fryklund B, Kuhn I, Burman L . Influence of antibiotic therapy on faecal carriage of P-fimbriated Escherichia coli and other gram-negative bacteria in neonates. J Antimicrob Chemother. 1988; 22(4):563-8. DOI: 10.1093/jac/22.4.563. View

17.

Moller J . Antimicrobial usage and microbial resistance in a university hospital during a seven-year period. J Antimicrob Chemother. 1989; 24(6):983-92. DOI: 10.1093/jac/24.6.983. View

18.

Schwalbe R, Stapleton J, Gilligan P . Emergence of vancomycin resistance in coagulase-negative staphylococci. N Engl J Med. 1987; 316(15):927-31. DOI: 10.1056/NEJM198704093161507. View

19.

Mouton R, Hermans J, Simoons-Smit A, Hoogkamp-Korstanje J, Degener J, van Klingeren B . Correlations between consumption of antibiotics and methicillin resistance in coagulase negative staphylococci. J Antimicrob Chemother. 1990; 26(4):573-83. DOI: 10.1093/jac/26.4.573. View

20.

Dryden M, Talsania H, McCann M, Cookson B, Phillips I . The epidemiology of ciprofloxacin resistance in coagulase-negative staphylococci in CAPD patients. Epidemiol Infect. 1992; 109(1):97-112. PMC: 2272240. View