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Methicillin-Resistant Staphylococcus aureus in Two Tertiary-Care Centers in Jeddah, Saudi Arabia

  • Tariq A. Madani (a1) (a2), Nabeela A. Al-Abdullah (a2), Ali A. Al-Sanousi (a3), Tawfik M. Ghabrah (a4), Shadia Z. Afandi (a5) and Huda A. Bajunid (a5)...
Abstract
Abstract <span class='bold'>Objective:</span>

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

<span class='bold'>Design:</span>

Retrospective review for the year 1998.

<span class='bold'>Setting:</span>

Two tertiary-care hospitals.

<span class='bold'>Methods:</span>

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.

<span class='bold'>Results:</span>

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.

<span class='bold'>Conclusions:</span>

The prevalence of MRSA is high and rapidly increasing in the two hospitals, as it is worldwide. Control measures to prevent die spread of MRSA in hospitals should continue, with reinforcement of hygienic precautions and development of policies to restrict the use of antibiotics.

Copyright
Corresponding author
Department of Internal Medicine, King Abdulaziz University Hospital, PO Box 80215, Jeddah 21589, Saudi Arabia
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2. LD Saravolatz , N Markowitz , L Arking , D Pohlod , E Fisher . MRSA epidemiologic observations during a community-acquired outbreak. Ann Intern Med 1982;96:1116.

3. F Moreno , C Crisp , JH Jorgensen , JE Patterson . Methicillin-resistant Staphylococcus aureus as a community organism. Clin Infect Dis 1995;21:13081312.

4. KR Pate , RL Nolan , TL Bannerman , S Feldman . Methicillin-resistant Staphylococcus aureus in the community. Lancet 1995;346:978.

5. J Embil , K Ramotar , L Romance , M Alfa , J Conly , S Cronk , et al. Methicillin-resistant Staphylococcus aureus in tertiary care institutions on the Canadian prairies 1990-1992. Infect Control Hasp Epidemiol 1994;15:646651.

6. BC Herold , LC Immergluck , MC Maranan , DS Lauderdale , RE Gaskin , S Boyle-Vavra , et al. Community-acquired methicillin-resistant Staphylococcus aureus in children with no identified predisposing risk. JAMA 1998;279:593598.

7. JM Boyce . Increasing prevalence of methicillin-resistant Staphylococcus aureus in the United States. Infect Control Hosp Epidemiol 1990;11:639642.

8. A Voss , D Milatovic , C Wallrauch-Schwarz , VT Rosdahl , I Braveny . Methicillin-resistant Staphylococcus aureus in Europe. Eur J Clin Microbiol Infect Dis 1994;13:5055.

10. JL Vincent , DJ Bihari , PM Suter , HA Bruining , J White , MH Nicolas-Chanoin , et al. The prevalence of nosocomial infection in intensive care units in Europe. Results of the European Prevalence of Infection in Intensive Care (EPIC) Study. EPIC International Advisory Committee. JAMA 1995;274:639644.

11. C Vandenbroucke-Grauls . Management of methicillin-resistant Staphylococcus aureus in The Netherlands. Rev Med Microbiol 1998;9:109116.

12. YA Hanifah , K Hiramatsu , T Yokota . Characterization of methicillin-resistant Staphylococcus aureus associated with nosocomial infection in the University Hospital, Kuala Lumpur. J Hosp Infect 1992;21:1528.

15. CA Hart , S Kariuki . Antimicrobial resistance in developing countries. BMJ 1998;317:647650.

18. AL Panlilio , DH Culver , RP Gaynes , S Banerjee , TS Henderson , JS Tolson , et al. Methicillin-resistant Staphylococcus aureus in US hospitals, 1975-1991. Infect Control Hosp Epidemiol 1992;13:582586.

19. FD Lowy . Staphylococcus aureus infections. N Engl J Med 1998;339:520532.

20. DCE Speller , AP Johnson , D James , RR Marples , A Charlett , RC George . Resistance to methicillin and other antibiotics in isolates of Staphylococcus aureus from blood and cerebrospinal fluid, England and Wales, 1989-95. Lancet 1997;350:323325.

21. S Mayor . England sets standards to reduce hospital acquired infection. BMJ 1999;319:1392.

22. CC Linnemann , P Moore , JL Staneck , MA Pfaller . Reemergence of epidemic methicillin-resistant Staphylococcus aureus in a general hospital associated with changing staphylococcal strains. Am J Med 1991;91(suppl 3B):238344.

23. MD Nettleman , A Trilla , M Fredrickson , MA Pfaller . Assigning responsibility: using feedback to achieve sustained control of methicillin-resistant Staphylococcus aureus. Am J Med 1991;91(suppl 3B):228232.

24. MC Layton , WJ Hierholzer , JE Patterson . The evolving epidemiology of methicillin-resistant Staphylococcus aureus at a university hospital. Infect Control Hosp Epidemiol 1995;16:1217.

25. LJ Strausbaugh , C Jacobson , DL Sewell , S Potter , TT Ward . Methicillin-resistant Staphylococcus aureus in extended-care facilities: experiences in a Veterans Affairs nursing home and a review of the literature. Infect Control Hosp Epidemiol 1991;12:3645.

26. R Coello , J Jimenez , M Garcia , P Arroyo , D Minguez , C Fernandez , et al. Prospective study of infection, colonization and carriage of methicillin-resistant Staphylococcus aureus in an outbreak affecting 990 patients. Eur J Clin Microbiol Infect Dis 1994;13:7481.

27. JN Longfield , TR Townsend , DF Cruess , M Stephen , C Bishop , E Bolyard , et al. Methicillin-resistant Staphylococcus aureus (MRSA): risk and outcome of colonized vs infected patients. Infect Control 1985;6:445450.

28. JP Myers , CC Linnemann . Bacteraemia due to methicillin-resistant Staphylococcus aureus. J Infect Dis 1982;145:532536.

29. GL French , AF Cheng , JM Ling , P Mo , S Donnan . Hong Kong strains of methicillin-resistant and methiciUin-sensitive Staphylococcus aureus have similar virulence. J Hosp Infect 1990;15:117125.

30. S Harbarth , O Rutschmann , P Sudre , D Pittet . Impact of methicillin resistance on the outcome of patients with bacteremia caused by Staphylococcus aureus. Arch Intern Med 1998;158:182189.

31. J Romero-Vivas , M Rubio , C Fernandez , JJ Picazo . Mortality associated with nosocomial bacteremia due to methicillin-resistant Staphylococcus aureus. Clin Infect Dis 1995;21:14171423.

32. LO Conterno , SB Wey , A Castelo . Risk factors for mortality in Staphylococcus aureus bacteremia. Infect Control Hosp Epidemiol 1998;19:3237.

33. K Hiramatsu , H Hanaki , T Ino , K Yabuta , T Oguri , FC Tenover . Methicillin-resistant Staphylococcus aureus clinical strain with reduced vancomycin susceptibility. J Antimicrob Chemother 1997;40:135136.

34. K Hiramatsu , N Aritaka , H Hanaki , S Kawasaki , Y Hosoda , S Hori , et al. Dissemination in Japanese hospitals of strains of Staphylococcus aureus heterogeneously resistant to vancomycin. Lancet 1997;350:16701673.

35. TL Smith , ML Pearson , KR Wilcox , C Cruz , MV Lancaster , B Robinson-Dunn , et al. Emergence of vancomycin resistance in Staphylococcus aureus. Glycopeptide-Intermediate Staphylococcus aureus Working Group. N Engl J Med 1999;340:493501.

36. FC Tenover . Implications of vancomycin-resistant Staphylococcus aureus. J Hosp Infect 1999;43(suppl):37.

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Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
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