[A study on MRSA infections and replacement of bacteria. Efficacy of vancomycin-ceftazidime combination therapy]

We analyzed the results of bacteriological tests on patients with MASA infections admitted to Osaka Prefectural Hospital, for the past 10 years. The conclusions obtained are as follows. 1. In our hospital, MRSA infections accounted for 50% or more of all Staphylococcus aureus infections in 1983 and 1984 (in the first half of the 1980's), markedly decreased to about 10% after 1988, because of the preventive measures taken against nosocomial infections and initiation of anti-MRSA treatment. During the latter period, use of antibiotics including third generation cephems was not especially restricted. 2. Glucose non-fermentative Gram-negative rods (GNF-GNR) or yeasts co-isolated with S. aureus were more frequent in MRSA infected patients, than those in MSSA infected patients. 70 to 80% of GNF-GNR were P. aeruginosa. 3. Sensitivities of MRSA to drugs were studied. VCM was most active, followed by arbekacin and rifampicin. Effectiveness against co-isolated GNF-GNR was high with ofloxacin, netilmicin and ceftazidime (CAZ). Therefore, is expected that, to prevent the replacement of opportunistic infections, combination therapies using vancomycin and CAZ would be effective.