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Methicillin-Resistant Staphylococcus aureus: How Reliable is Laboratory Reporting?

Published online by Cambridge University Press:  02 January 2015

David W. Fleming ,
Steven D. Helgerson ,
Barbara L. Mallery ,
Laurence R. Foster  and
Mary C. White
David W. Fleming
Affiliation:
Respiratory and Special Pathogens Branch, Center for Infectious Disease, Atlanta, Georgia Office of the Director, Centers for Disease Control, Atlanta, Georgia
Steven D. Helgerson
Affiliation:
Respiratory and Special Pathogens Branch, Center for Infectious Disease, Atlanta, Georgia Office of the Director, Centers for Disease Control, Atlanta, Georgia
Barbara L. Mallery
Affiliation:
Respiratory and Special Pathogens Branch, Center for Infectious Disease, Atlanta, Georgia Office of the Director, Centers for Disease Control, Atlanta, Georgia
Laurence R. Foster*
Affiliation:
Respiratory and Special Pathogens Branch, Center for Infectious Disease, Atlanta, Georgia Office of the Director, Centers for Disease Control, Atlanta, Georgia
Mary C. White
Affiliation:
Respiratory and Special Pathogens Branch, Center for Infectious Disease, Atlanta, Georgia Office of the Director, Centers for Disease Control, Atlanta, Georgia
*
Oregon Health Division, 1400 S.W. Fifth Avenue, Portland, OR 97201
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Abstract

Microbiology laboratories in Oregon were surveyed in 1981 to determine how often methicillin-resistant Staphylococcus aureus (MRSA) was being reported to physicians in the state. Results of this survey were surprising in three respects. First, the mean percent of S. aureus isolates reported by laboratories as methicillin-resistant was 8.3%. Second, a significant inverse correlation was found between the percent of reported MRSA and laboratory size (p=0.0001). Finally, laboratories which retested initially resistant isolates reported significantly less MRSA (mean 3.3%, median 1%) than those laboratories which accepted initial results (mean 20%, median 12%) (p=0.0001). Independent testing by the Centers for Disease Control of isolates reported to be MRSA confirmed that some misideiitification was occurring. Participating laboratories were notified of our initial findings and their potentially serious clinical ramifications. Laboratories were resurveyed in 1982, and a significant decrease in the reported MRSA to a mean percentage of 3.4% was observed (p=<0.002). It is unlikely that this situation is unique to Oregon, and similar misreporting of MRSA to physicians in other areas of the country may be compromising the safe and effective treatment of S. aureus infections.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 7 , Issue 3 , March 1986 , pp. 164 - 167
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1986

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References

1.Jovons, MP, “Celbenen”-resistant staphylococci. Br Med J 1961;1::124–125.CrossRefGoogle Scholar
2.Klimek, J, Marsik, F, Bartlett, R, et al: C'link al epidemiologic and bacteriologie observations of an outbreak of methicillin-resistant Staphylococcus aureus al a large community hospital. Am J Med 1976;61:340–345.CrossRefGoogle Scholar
3.Crossley, K, Landeman, B. Zaske, D, An outbreak of infections caused by strains of Staphylococcus aureus resistant to methicillin and aminoglycosides. 11. F.pi-demiologic studies. J Infect Dis 1979;139(31):280–287.CrossRefGoogle Scholar
4.Peacock, JE jr, Marsik, FJ, Wenzel, RP, Methicillin-resistant Staphylococcus aureus: Introduction and spread within a hospital. Ann Intern Med 1980;93:526–532.CrossRefGoogle ScholarPubMed
5.Saravolatz, L, Pohled, ID, Arking, L, Community acquired methicillin-resistant Staphylococcus aureus infections: A new source for nosocomial outbreaks. Ann Intern Med 1982;97:325–329.CrossRefGoogle ScholarPubMed
6.Levine, D, Gushing, R, Jui, J, et al: Coimiimiity-acqiiired methicillin-resistant Staphylococcus aureus endocarditis in the Detroit Medical (lentei). Ann Intern Med 1982;97:330–338.CrossRefGoogle Scholar
7.Haley, R, Hightower, A, Khabbaz, R, et al: llie emergence of methicillin-resistant Staphylococcus aureus infections in United Stales hospitals. Ann Intern Med 1982;97:297–308.CrossRefGoogle Scholar
8.Zone diameter interpretive standards and approximate minimum inhibitory concentration (MIC) correlates. Nat Com Clin Lab Stds 1981;1(6): 148–151.Google Scholar
9.Bauer, AW, Kirby, WM, Sherris, JC, et al: Antibiotic susceptibility testing by a standardized single disc method. Am j Clin Pathol 1966;45(4:493–496.CrossRefGoogle Scholar
10.Drew, WL, Barry, AL, Ololle, R, et al: Reliability of the Kirby-Bauer disc dif fusion method for detecting methicillin-resistant strains of Staphylococcus aureus. Appl Microbiol 1972;24:240–247.CrossRefGoogle Scholar
11.Richard, S, Simberkoff, M, Schaeffer, S, et al: Resistance ol Staphylococcus aureus to semisynthetic penicillins and cephalothin. J Infect Dis 1977;135:108–112.Google Scholar
12.Acar, J, Courvalin, P, Chabbert, Y, Methicillin-resistant staphylococcemia: Bacteriologie failure of treatment with cephalosporins. Proceedings of the 10th Interscience Conference on Antimicrobial Agents and Chemotherapy. Chicago, Illinois, October 1970. American Society for Microbiology, Washington, DC, 1971;180–185.Google Scholar
13.Rules and Regulations. Antibiotic susceptibility discs, federal Register 1973;38:2576.Google Scholar