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Methicillin resistant Staphylococcus aureus
1Faculty of Medical Sciences, Eric Williams Medical Sciences Complex, Mount Hope, Trinidad.
Abstract:
The prevalence of methicillin resistant Staphylococcus aureus (MRSA) at the General Hospital, Port-of-Spain, between June 1995 and May 1996 was determined. The MRSA prevalence rate was 4.6% of all S aureus isolates, with all but one nosocomially acquired. 15 isolates were associated with infections, and three were colonizing strains. 17 of the 18 patients with MRSA had received antibiotics previously, including 13 who had received multiple antibiotics. Skin and soft tissue were the sites of infection and colonization in 12 cases; and surgical wards and the Intensive Care Unit (ICU) accounted for 16 MRSA isolates. All isolates were sensitive to vancomycin and all but one were resistant to gentamicin. MRSA occurred sporadically in a wide distribution of wards and physicians' services, although the isolation of three strains from the ICU and three strains from a surgical ward were temporally related. Only one of two deaths was attributable to MRSA. Control of the spread of MRSA in this hospital must include the reinforcement of the appropriate use of antibiotics, hand washing and appropriate isolation of patients in the surgical and intensive care wards.
Insights
Methicillin-resistant Staphylococcus aureus (MRSA) prevalence was 4.6% at Port-of-Spain General Hospital. Most MRSA cases were hospital-acquired, emphasizing the need for antibiotic stewardship and infection control.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Hospital Epidemiology
Background:
- Methicillin-resistant Staphylococcus aureus (MRSA) poses a significant threat in healthcare settings.
- Understanding local prevalence and risk factors is crucial for effective control strategies.
Purpose of the Study:
- To determine the prevalence of MRSA at the General Hospital, Port-of-Spain.
- To identify associated risk factors and clinical characteristics of MRSA infections and colonization.
Main Methods:
- Prospective surveillance of Staphylococcus aureus isolates between June 1995 and May 1996.
- Analysis of MRSA isolate prevalence, patient demographics, infection sites, and antibiotic exposure.
- Antimicrobial susceptibility testing.
Main Results:
- MRSA prevalence was 4.6% of all S. aureus isolates; nearly all were nosocomially acquired.
- Skin and soft tissue infections/colonization were most common (12 cases).
- 17 of 18 MRSA patients had prior antibiotic exposure; all isolates were vancomycin-sensitive but mostly gentamicin-resistant.
Conclusions:
- MRSA was present sporadically across wards, with temporal clusters in the ICU and surgical wards.
- Reinforcing appropriate antibiotic use, hand hygiene, and patient isolation is essential for MRSA control.
- Effective MRSA management requires a multi-faceted approach including strict adherence to infection prevention protocols.