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A Comparison of Pneumonia Caused by Gentamicin, Methicillin-Resistant and Gentamicin, Methicillin-Sensitive Staphylococcus aureus: Epidemiologic and Clinical Studies

Published online by Cambridge University Press:  02 January 2015

Joseph R. Lentino ,
Hani Hennein ,
Sally Krause ,
Sharon Pappas ,
Gail Fuller ,
Doris Schaaff  and
Mary Beth DiCostanzo
Joseph R. Lentino*
Affiliation:
Medical Service, Section of Infectious Disease, the Hospital Infection Surveillance and Control Section, Edward Hines Jr. Veterans Administration Hospital, Hines, Illinois, the Department of Medicine, Loyola University Stritch School of Medicine, Maywood, Illinois, and the Departments of Medicine and Preventive Medicine and Community Health, University of Illinois at Chicago, Chicago, Illinois
Hani Hennein
Affiliation:
Medical Service, Section of Infectious Disease, the Hospital Infection Surveillance and Control Section, Edward Hines Jr. Veterans Administration Hospital, Hines, Illinois, the Department of Medicine, Loyola University Stritch School of Medicine, Maywood, Illinois, and the Departments of Medicine and Preventive Medicine and Community Health, University of Illinois at Chicago, Chicago, Illinois
Sally Krause
Affiliation:
Medical Service, Section of Infectious Disease, the Hospital Infection Surveillance and Control Section, Edward Hines Jr. Veterans Administration Hospital, Hines, Illinois, the Department of Medicine, Loyola University Stritch School of Medicine, Maywood, Illinois, and the Departments of Medicine and Preventive Medicine and Community Health, University of Illinois at Chicago, Chicago, Illinois
Sharon Pappas
Affiliation:
Medical Service, Section of Infectious Disease, the Hospital Infection Surveillance and Control Section, Edward Hines Jr. Veterans Administration Hospital, Hines, Illinois, the Department of Medicine, Loyola University Stritch School of Medicine, Maywood, Illinois, and the Departments of Medicine and Preventive Medicine and Community Health, University of Illinois at Chicago, Chicago, Illinois
Gail Fuller
Affiliation:
Medical Service, Section of Infectious Disease, the Hospital Infection Surveillance and Control Section, Edward Hines Jr. Veterans Administration Hospital, Hines, Illinois, the Department of Medicine, Loyola University Stritch School of Medicine, Maywood, Illinois, and the Departments of Medicine and Preventive Medicine and Community Health, University of Illinois at Chicago, Chicago, Illinois
Doris Schaaff
Affiliation:
Medical Service, Section of Infectious Disease, the Hospital Infection Surveillance and Control Section, Edward Hines Jr. Veterans Administration Hospital, Hines, Illinois, the Department of Medicine, Loyola University Stritch School of Medicine, Maywood, Illinois, and the Departments of Medicine and Preventive Medicine and Community Health, University of Illinois at Chicago, Chicago, Illinois
Mary Beth DiCostanzo
Affiliation:
Medical Service, Section of Infectious Disease, the Hospital Infection Surveillance and Control Section, Edward Hines Jr. Veterans Administration Hospital, Hines, Illinois, the Department of Medicine, Loyola University Stritch School of Medicine, Maywood, Illinois, and the Departments of Medicine and Preventive Medicine and Community Health, University of Illinois at Chicago, Chicago, Illinois
*
Section of Infectious Disease (IIIP), Hines Veterans Administration Hospital, Hines, IL 60141
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Abstract

We investigated an outbreak of nosocomial pneumonia due to gentamicin, methicillin-resistant Staphylococcus aureus (GMRSA). We compared the predisposing factors for pneunomia due to GMRSA to those for pneumonia due to gentamicin, methicillin-sensitive Staphylococcus aureus (GMSSA). Seventeen of 29 patients with staphylococcal pneumonia were infected with GMRSA. Risk factors and associated diseases which selected for infection with GMRSA as opposed to GMSSA included prior antibiotic therapy for a prolonged period of time (p = 0.0001), number of risk factors per patient (p = 0.0001), days hospitalized prior to diagnosis of pneumonia (p = 0.002) and number of associated diseases per patient (p = 0.002).

Despite the epidemiologic differences between GMSSA and GMRSA pneumonia, there were no differences in the clinical presentation, course of illness, complications, response to appropriate therapy or outcome between the two groups. Survival was adversely affected by age only among the GMSSA patients (p = 0.02) and by the number of associated diseases (p = 0.005).

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 6 , Issue 7 , July 1985 , pp. 267 - 272
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1985

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References

1.Crossley, K, Loesch, D, Landesnian, B, et al: An outbreak of infections caused by strains of Staphylococcus aureus resistant to nielliicillin and aminoglycosides. I. Clinical Studies. J Infect Dis 1979; 139:273–279.Google Scholar
2.Crossley, K, Landesnian, B, Zaske, D: An outbreak of infections caused by strains of Staphylococcus aureus resistant to methicillin and aminoglycosides. II. Epidemiologic Studies. J Infect Dis 1979; 139:280–287.CrossRefGoogle ScholarPubMed
3.Dunkle, LM, Naqvi, SH, McCallum, R. et al: Eradication of epidemic melhicillin-gentamicin-resisiant Staphylococcus aureus in an intensive care nursery. Am J Med 1981; 70:455–458.Google Scholar
4.Craven, DE, Reed, C. Kollisch, N, et al: A large outbreak of infections caused by a strain of Staphylococcus aureus resistant to oxacillin and aminoglycosides. Amer J Med 1981; 71:53–58.Google Scholar
5.Kloos, WE. Smith, PB: Staphylococci, in Lenitene, EH, Balows, A, Hauser, WI Jr, Truant, JP (eds) Manual of Clinical Microbiology, ed 3. Washington. D.C. American Society for Microbiology. 1980, pp 83–87.Google Scholar
6.Bauer, AW, Kirby, WMM, Shenis, JC, et al: Antibiotic susceptibility testing by a standardized single disk method. Am J Clin Pathol 1966; 45:493–496.CrossRefGoogle ScholarPubMed
7.Aldridge, KE, Janney, A, Sanders, CV, et al: Interlaboratory variation of anti-biograms of melhicillin-resistant and methicillin-susceptible Staphylococcus aureus strains with conventional and commercial testing systems. J Clin Microbiol 1983; 18:1226–1236.Google Scholar
8.Thornsberry, C, McDougal, LK: Successful use of broth microdilution in susceptibility tests for melhicillin-resistant (Heteroresistant) staphylococci. J Clin Microbiol 1983; 18:1084–1091.CrossRefGoogle ScholarPubMed
9.Taylor, PC, Schoenknechl, FD, Sherris, JC, et al: Determination of minimum bactericidal concentrations of oxacillin for Staphylococcus aureus: Influence and significance of technical factors. Antimicrob Agents Chemother 1983; 23:142–150.Google Scholar
10.Sabath, LD: Mechanisms of resistance to beta-lactani antibiotics in strains of Staphytococcus aureus. Ann Intern Med 1982: 97:339–344.Google Scholar
11.Snedecor, GW, Cochnan, WC: Statistical Methods, ed 6. Ames. Iowa, Iowa Siale University Press, 1969, pp 59-62, 116–118.Google Scholar
12.Cupples, LA, Heeren, P, Schaizkin, A. et al: Multiple testing of hypotheses in comparing two groups. Ann Intern Med 1983; 100:122–129.Google Scholar
13.Ray, AA (ed): The Funcat Procedure in SAS User's Guide: Statistics. 1982 ed. Cary, North Carolina, SAS Institute Inc, 1982, pp 257–285.Google Scholar
14.Archer, GL, Mayhall, GG: Comparison of epidemiological methods used in the investigation of an outbreak of melhicillin-resistant Staphylococcus aureus infections. Clin Microbiol 1983; 18:395–399.CrossRefGoogle Scholar
15.Arnow, PM, Allyn, PA, Nichols, EM. et al: Control of melhicillin-resistant Staphylococcus aureus in a burn unit: Role of nurse staffing. Trauma 1982; 22:954–959.Google Scholar
16.du Moulin, CC, Dasse, P, Miller, MG, et al: Staphylococcal outbreak in an intensive care unit—A narrative account of its management. Heart and Lung 1979; 8:94–99.Google Scholar
17.Peacock, JE Jr, Moorman, DR, Wenzel, RP. et al: Methicillin-resistant Staphylococcus aureus: Microbiologic characteristics, antimicrobial susceptibilities, and assessment of virulence of an epidemic strain. J Infect Dis 1981; 144:575–582.Google Scholar
18.Myers, JP. Linnemann, CC Jr: Bacteremia due to methicillin-resistant Staphylococcus aureus. J Infect Dis 1982; 145:532–536.Google Scholar
19.Haley, RW, Hightower, AW, Khabbaz, RF, et al, : The emergence of methicillin-resistant Staphylococcus aureus. Ann Intern Med 1982; 97:297–308.Google Scholar
20.Thompson, RL, Cabezudo, I, Wenzel, RP: Epidemiology of nosocomial infections caused by melhicillin-resistant Staphylococcus aureus. Ann Intern Med 1982;97:309–317.CrossRefGoogle ScholarPubMed
21.Locksley, RM. Cohen, ML, Quinn, TC. et al: Multiply antibiotic-resistant Staphylococcus aureus: Introduction, transmission, and evolution of nosocomial infection. Ann Intern Med 1982; 97:317–324.CrossRefGoogle ScholarPubMed
22.Boyce, JM, Landry, M, Deetz, TR, et al: Epidemiologie studies of an outbreak of nosocomial methicillin-resistant Staphylococcus aureus infections. Infect Control 1981;70:455–458.Google Scholar
23.Ward, TTWinn, RE, Hartstein, AI, et al: Observations relating to an inter-hospital outbreak of methicillin-resistant Staphylococcus aureus: Role of antimicrobial therapy in infection control. Infect Control 1981; 2:453–459.Google Scholar
24.Wenzel, RP, Donowitz, L, Miller, GB Jr: Methicillin-resistant Staphylococcus aureus—United States. MMWR 1981;30:140, 145–147.Google Scholar
25.Boyce, JM, Causey, WA: Increasing occurrence of methicillin-resistant Staphylococcus aureus— United States. Infect Control 1982; 3:337–383.Google Scholar
26.Saroglou, G, Cromer, M, Bisno, AL: Methicillin-resistant Staphylococcus aureus: Interstate spread of nosocomial infections with emergence of gentaniicin-nielhicillin resistant strains. Infect Control 1980; 1:81–89.CrossRefGoogle ScholarPubMed
27.Boyce, JM, White, RL, Causey, WA, et al: Burn units as a source of methicillin-resistant Staphylococcus aureus infections. JAMA 1983; 249:2803–2807.Google Scholar
28.Esperson, R, Gabrielsen, J: Pneumonia due to Staphylococcus aureus during mechanical ventilation. J Infect Dis 1981; 144:19–23.Google Scholar
29.Saravolalz, LD, Pohlod, DJ, Arking, LM: Community-acquired melhicillin-resistant Staphylococcus aureus infections: A new source for nosocomial outbreaks. Ann Intern Med 1982; 97:325–329.CrossRefGoogle Scholar