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[Oxacillin and gentamicin-resistant Staphylococcus aureus: surveillance and development over a period of 6 months]
Abstract:
An outbreak of nosocomial infections caused by oxacillin and gentamicin-resistant Staphylococcus aureus occurred over a 3 month period in the intensive care unit of a 371-bed hospital. Four patients were infected. S. aureus isolates were resistant to multiple antibiotics beside oxacillin and gentamicin. They exhibited identical antibiotic susceptibility pattern and identical phage type (47/54/75/77/84/85). A subsequent survey of oxacillin-resistant S. aureus was conducted in the hospital during a 6 month period. Bacteriophage typing was performed on 52 isolates of oxacillin-resistant S. aureus. Seventeen were non typeable . Fourteen had the same phage type (or a minor variant +/- 2 numbers) as that of the previously isolated S. aureus. The antibiotic susceptibility pattern of 10 of the 14 isolates was identical to that of the epidemic strain. The antibiotic susceptibility patterns of 2 isolates differed from it with respect to the resistance to one antibiotic among those tested (these two isolates were obtained from patients that received the particular antibiotic before the isolation of the Staphylococcus). The 7 patients from whom these 12 S. aureus were isolated were staying in the intensive care unit except one who was hospitalized in this unit several months ago. Among the personnel screened, two intensive care unit nurses were found to be nasal carriers of oxacillin resistant S. aureus. One strain had the same phage type as that of the epidemic strain but its antibiotic susceptibility pattern was different. Room-mate to room-mate spread within the intensive care unit may be responsible for the perpetuation of the epidemic strain.(ABSTRACT TRUNCATED AT 250 WORDS)
Insights
An outbreak of resistant Staphylococcus aureus in an intensive care unit (ICU) was investigated. The study identified nasal carriage in ICU nurses and suggests room-mate spread contributes to the perpetuation of the epidemic strain.
Area of Science:
- Infectious Diseases
- Microbiology
- Hospital Epidemiology
Context:
- Nosocomial infections pose a significant threat in healthcare settings, particularly in intensive care units (ICUs).
- Antibiotic-resistant bacteria, such as oxacillin-resistant Staphylococcus aureus (ORSA), present a growing challenge in infection control.
- Outbreaks of resistant pathogens require rapid identification and control strategies to prevent further spread.
Purpose:
- To investigate an outbreak of nosocomial infections caused by oxacillin and gentamicin-resistant Staphylococcus aureus in a hospital's ICU.
- To characterize the antibiotic susceptibility and phage type of the causative S. aureus strains.
- To identify potential sources and transmission routes of the resistant bacteria within the hospital.
Summary:
- An outbreak involving four patients infected with multi-drug resistant Staphylococcus aureus occurred in an ICU.
- Subsequent surveillance identified 14 additional ORSA isolates with similar phage types and antibiotic resistance patterns to the outbreak strain.
- Nasal carriage of ORSA was detected in two ICU nurses, and room-mate to room-mate spread was implicated in transmission.
Impact:
- Highlights the importance of robust infection control measures in ICUs to manage outbreaks of antibiotic-resistant bacteria.
- Identifies healthcare personnel as potential reservoirs and transmission vectors for resistant pathogens.
- Provides insights into the epidemiology and control of Staphylococcus aureus outbreaks in hospital environments.