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Resistance to cloxacillin among hospital staphylococci
Abstract:
Cloxacillin-resistant strains of Staphylococcus aureus were detected by their ability to grow on agar containing 1.6 mug./ml. of cloxacillin, a more reliable method than the disc-diffusion test. At Sefton General Hospital, Liverpool, between 1963 and 1965, there was an increase in the number of infections among in-patients that were caused by staphylococci resistant to cloxacillin despite the fact that use of the antibiotic was largely confined to an isolation ward for patients with staphylococcal sepsis. Although there is no evidence yet that staphylococci resistant to cloxacillin will become as common in hospital practice as those resistant to penicillin and tetracycline it is clear that there is a need for continued vigilance and measures to prevent spread of staphylococci from infected patients.
Insights
Cloxacillin resistance in Staphylococcus aureus increased in hospital patients despite limited antibiotic use. This highlights the need for vigilance against resistant bacteria spread.
Area of Science:
- Microbiology
- Infectious Diseases
- Hospital Epidemiology
Background:
- Cloxacillin resistance in Staphylococcus aureus (SA) is a growing concern.
- Traditional disc-diffusion tests may be less reliable for detecting cloxacillin resistance.
- Hospital-acquired infections (HAIs) caused by resistant SA pose a significant threat to patient safety.
Purpose of the Study:
- To evaluate a more reliable method for detecting cloxacillin-resistant SA.
- To investigate the incidence and patterns of cloxacillin-resistant SA infections in a hospital setting.
- To assess the effectiveness of antibiotic stewardship in controlling the spread of resistant SA.
Main Methods:
- Agar-based detection method using 1.6 mug./ml. cloxacillin for identifying resistant SA strains.
- Retrospective analysis of patient data from Sefton General Hospital (1963-1965).
- Comparison of agar-based detection with the disc-diffusion test.
Main Results:
- Agar-based detection proved more reliable than disc-diffusion for identifying cloxacillin-resistant SA.
- An increase in cloxacillin-resistant SA infections was observed among inpatients between 1963 and 1965.
- Despite restricted antibiotic use to an isolation ward, resistant strains emerged and spread.
Conclusions:
- A reliable method for detecting cloxacillin resistance in SA is crucial for effective infection control.
- The emergence of cloxacillin-resistant SA in a hospital setting necessitates ongoing surveillance.
- Preventive measures to curb the spread of resistant SA from infected patients are essential, even with limited antibiotic exposure.