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Hospital dispersion of Staphylococcus epidermidis isolates resistant to a fluoroquinolone, pefloxacin
1Centre National de Référence des Staphylocoques, Faculté de Médecine Alexis Carrel, Lyon, France.
Abstract:
Since 1985, nosocomial infections have been frequently treated with a new fluoroquinolone, pefloxacin, at the Cardiological and Neurological Hospital in Lyon. From 1986 to 1988, the incidence of resistance of clinical Staphylococcus epidermidis strains to pefloxacin increased from 31 to 57%. Dispersion of these resistant strains in the hospital environment was recognized when they were detected on 22% of staff members' fingers (139 samples were investigated) and in 28% of the environmental samples (180 were investigated). There was an association between carriage rate and work place. Most of the pefloxacin-resistant S. epidermidis were resistant to oxacillin, gentamicin, erythromycin, cotrimoxazole and fosfomycin. Intensive use of pefloxacin selected multiresistant S. epidermidis which became ubiquitous in the hospital environment.
Insights
The intensive use of pefloxacin led to a significant increase in pefloxacin-resistant Staphylococcus epidermidis strains. These resistant bacteria became widespread in the hospital environment, affecting both staff and surfaces.
Area of Science:
- Infectious Diseases
- Microbiology
- Hospital Epidemiology
Background:
- Pefloxacin, a fluoroquinolone, has been used since 1985 for nosocomial infections.
- An increasing incidence of pefloxacin resistance in Staphylococcus epidermidis was observed.
Purpose of the Study:
- To investigate the spread and characteristics of pefloxacin-resistant Staphylococcus epidermidis in a hospital setting.
Main Methods:
- Monitoring the incidence of pefloxacin resistance in clinical Staphylococcus epidermidis strains from 1986 to 1988.
- Investigating the presence of resistant strains on staff fingers and environmental surfaces.
- Assessing the antibiotic resistance profiles of the isolated strains.
Main Results:
- Pefloxacin resistance in Staphylococcus epidermidis rose from 31% to 57% between 1986 and 1988.
- Resistant strains were detected on 22% of staff fingers and 28% of environmental samples.
- Most resistant strains exhibited multidrug resistance to other antibiotics like oxacillin and gentamicin.
Conclusions:
- Intensive pefloxacin use selected for and promoted the ubiquity of multidrug-resistant Staphylococcus epidermidis in the hospital.
- The findings highlight the critical need for judicious antibiotic use to prevent the spread of antimicrobial resistance.