ROBERT J, BISMUTH R, LEMAITRE N, JARLIER V; Interscience Conference on Antimicrobial Agents and Chemotherapy.
Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2000 Sep 17-20; 40: 438.
Faculte de Medecine Pitie-Salpetriere, Paris, France
BACKGROUND: Since 1992, French hospitals are facing an outbreak of GS-MRSA that have partially replaced gentamicin-resistant MRSA (GR-MRSA). We studied factors related to GS-MRSA acquisition in 1996, including antimicrobials selection pressure and colonization pressure (number of contact with patients already colonized).METHODS: Case-control study comparing the characteristics of 63 GS-MRSA patients (cases) to those of 93 GR-MRSA patients (controls). Antibiotypes and PFGE patterns were used to assess cross-contamination with GS-MRSA.RESULTS: In 1996, 517 patients had a specimen positive for MRSA (incidence: 1% admissions), including 201 GS-MRSA and 316 GR-MRSA. The GS-MRSA strains of the 63 cases were grouped into 4 antibiotypes and 4 PFGE patterns. There was a good correlation between antibiotypes and PFGE patterns. Cases and controls were similar in duration of hospital stay, McCabe score, and opportunity of contact with a GS-MRSA patient (52% vs 46%). Cases were significantly more likely than controls to have been hospitalized in a ward where >50% of MRSA strains were GS-MRSA (36% vs 16%). In contrast, they were less likely than controls to: be admitted to a ward where >50% of MRSA strains were GR-MRSA (51% vs 75%), meet a GR-MRSA patients (48% vs 85%), and receive B-lactams (36% vs 66%) and aminoglycosides (10% vs 34%). In multivariate analysis, number of GS-MRSA contact-patients in the same ward was associated with GS-MRSA acquisition (OR=3.0; 95%CI 1.2-7.3), and number of GR-MRSA contact-patients (OR=0.2; 95%CI 0.1-0.5), treatment with B-lactams (OR=0.4; 95%CI 0.2-0.8) and aminoglycosides (OR=O.8; 95%CI 0.7-1.0) were protective. Conclusion: Our data shows that antimicrobials selection pressure and colonization pressure play a major role in GS-MRSA acquisition.KEYWORDS: Gentamicin; Methicillin resistance; Staphylococci
Publication Types:
Keywords:
- Aminoglycosides
- Anti-Bacterial Agents
- Case-Control Studies
- Disease Outbreaks
- Electrophoresis, Gel, Pulsed-Field
- Gentamicins
- Hospitals
- Hospitals, Teaching
- Humans
- Methicillin Resistance
- Risk Factors
- Staphylococcal Infections
- Staphylococcus aureus
Other ID:
UI: 102247639
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