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Staphylococcal infections in hospital: the Greek experience
J Kosmidis1, C Polychronopoulou-Karakatsanis, D Milona-Petropoulou
1First Department of Medicine, General Hospital, Athens, Greece.
Abstract:
Resistance rates of various species to many antimicrobials are very high in Greece. Mean resistance rates of Staphylococcus aureus isolated in 12 Athens hospitals in the second half of 1986 were 80% for penicillin, 32% for methicillin, 22% for gentamicin, 27% for erythromycin, 17% for lincomycin and 16% for co-trimoxazole. In a prospective study in the General Hospital of Athens from May to July 1987, 40 coagulase-positive staphylococcal strains were isolated from various materials from inpatients. Of these 78% were resistant to penicillin, 50% to methicillin at 37 degrees C, 62% to methicillin at 30 degrees C, 38% to erythromycin, 32% to tobramycin, 15% to clindamycin, 15% to fusidic acid, 9% to amikacin, 5% to netilmicin and 0% to vancomycin. Ten of these strains (seven methicillin-resistant) were responsible for severe infections and three of the affected patients died (two nosocomial pneumonias, one infected burn, all due to methicillin-resistant strains). Another 11 strains (eight methicillin-resistant) were responsible for mild infections. From 41 coagulase-negative staphylococci isolated from inpatients, seven (five methicillin-resistant) were held responsible for mild infections. Of the 20 patients with infections due to methicillin-resistant strains, nine had previously received a beta- lactam antibiotic. Staphylococci are not responsible, however, for a large proportion of infections in our hospital at the moment. High resistance rates in Greece are due to overuse of antibiotics, a phenomenon attributed to a consumer's society behaviour of doctors and patients.
Insights
High antimicrobial resistance rates in Greece, particularly for Staphylococcus aureus, are evident. Overuse of antibiotics by doctors and patients contributes to this significant public health concern.
Area of Science:
- Microbiology
- Infectious Diseases
- Public Health
Background:
- High antimicrobial resistance rates are a growing global concern.
- Staphylococcus aureus is a significant pathogen with increasing resistance to common antibiotics.
- Greece has reported elevated resistance levels in various bacterial species.
Purpose of the Study:
- To assess the antimicrobial resistance patterns of Staphylococcus aureus and coagulase-negative staphylococci in Greek hospitals.
- To determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) infections.
- To identify potential factors contributing to high resistance rates.
Main Methods:
- Prospective study conducted in Athens hospitals from May to July 1987.
- Isolation and susceptibility testing of coagulase-positive and coagulase-negative staphylococcal strains from inpatient materials.
- Analysis of resistance rates to various antimicrobials, including penicillin, methicillin, and others.
Main Results:
- High resistance rates observed for Staphylococcus aureus: 80% to penicillin, 50% to methicillin (37°C).
- Methicillin-resistant Staphylococcus aureus (MRSA) strains were responsible for severe infections, including fatal cases of nosocomial pneumonia and infected burns.
- Coagulase-negative staphylococci also exhibited significant methicillin resistance.
Conclusions:
- Antimicrobial resistance, especially MRSA, poses a substantial threat in Greece.
- Overuse of antibiotics, driven by societal behavior of both prescribers and patients, is a primary cause of high resistance.
- Urgent interventions are needed to curb antibiotic misuse and mitigate resistance spread.