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Clinical studies of enteritis caused by methicillin-resistant Staphylococcus aureus
K Takeuchi1, Y Tsuzuki, T Ando
1The Department of Surgery, Tone Chuo Hospital, Numata-city, Gunma, Japan.
Objective:
To study the clinical features of methicillin-resistant Staphylococcus aureus (MRSA) enteritis in our surgical ward.
Design:
Retrospective study.
Setting:
Teaching hospital, Japan.
Subjects:
16 men and 1 woman who developed MRSA enteritis from January 1995 to October 1999.
Main Outcome Measures:
Causes and treatments.
Results:
The underlying diseases were as follows: gastric cancer (n = 13), colorectal cancer (n = 2), recurrent cancer (n = 1) and bowel obstruction following gastrectomy (n = 1). 16 patients were operated on. Two cases were treated with histamine H2 receptor blockers. The mean age of patients was 65 years (range 50-80). In 13 cases MRSA enteritis developed within 6 days of operation. 10 strains of MRSA were isolated from stools, 8 from gastric juice, and 3 from intra-abdominal exudate. 10 patients were treated with vancomycin given through a nasogastric tube and 2 through a nasogastric tube and by drip intravenous infusion. 15 patients survived and 2 died.
Conclusions:
Patients who are given broad-spectrum antibiotics and whose gastric secretion is reduced are at high risk of MRSA enteritis. In the surgical ward, early diagnosis, treatment, and isolation are essential for patients with MRSA enteritis.