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Methicillin-Resistant Staphylococcus aureus in Hospitals and Long-Term Care Facilities: Microbiology, Epidemiology, and Preventive Measures

Published online by Cambridge University Press:  21 June 2016

John M. Boyce
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Extract

Strains of methicillin-resistant Staphylococcus aureus (MRSA) have become increasingly common in the United States and in many other countries since 1975. Although MRSA was recovered primarily in university and federal hospitals in this country during the late 1970s, these organisms are being encountered with increasing frequency in all types of hospitals, especially in the eastern half of the United States. Although there is a paucity of information available on the prevalence of MRSA in long-term care facilities, a few reports suggest that MRSA is also seen frequently in these settings. Because colonized patients are frequently transferred between hospitals and long-term care facilities, a continuing circuit of MRSA transmission occurs in areas where these organisms are prevalent.

MRSA prevalence rates vary widely by locale and by type and size of hospital. In some geographic areas, the prevalence remains low, whereas in other areas, from 10% to 50% of all S aureus isolates recovered from patients in large medical centers are MRSA. Even within a given city, MRSA prevalence rates may vary widely among acute care hospitals.

Type
Special Review
Information
Infection Control & Hospital Epidemiology , Volume 13 , Issue 12 , December 1992 , pp. 725 - 737
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1992

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References

1. Boyce, JM, Causey, WA Increasing occurrence of methicillin-resistant Staphylococcus aureus in the United States. Infect Control. 1982;3:377–383.CrossRefGoogle ScholarPubMed
2. Haley, RW, Hightower, AW, Khabbaz, RF, et al. The emergence of methicillin-resistant Staphylococcus aureas infections in United States hospitals. Possible role of the house staff-patient transfer circuit. Ann Intern Med. 1982;97:297–308.CrossRefGoogle Scholar
3. Preheim, LC, Rimland, D, Bittner, MJ. Methicillin-resistant Staphylococcus aureus in Veterans Administration Medical Centers. Infect Control. 1987;8:191–194.CrossRefGoogle ScholarPubMed
4. Jarvis, WR, Thomsberry, C, Boyce, J, Hughes, JM. Methicillin-resistant Staphylococcus aureus at children's hospitals in the United States. Pediatr Infect Dis. 1985;4:651–655.CrossRefGoogle ScholarPubMed
5. Wakefield, DS, Pfaller, M, Massanari, RM, Hammons, GT. Variation in methicillin-resistant Staphylococcus aureus occurrence by geographic location and hospital characteristics. Infect Control. 1987;8:151–157.CrossRefGoogle ScholarPubMed
6. Brumfitt, W, Hamilton-Miller, J. Methicillin-resistant Staphylococcus aureus . N Engl J Med. 1989;320:1188–1196.CrossRefGoogle ScholarPubMed
7. Marples, RR, Cooke, EM. Current problems with methicillin-resistant Staphylococcus aureus . J Hosp Infect. 1988;11:381–392.Google ScholarPubMed
8. Cookson, BD, Phillips, I. Epidemic methicillin-resistant Staphylococcus aureus . J Antimicrob Chemother. 1988;21(suppl C):57–65.CrossRefGoogle ScholarPubMed
9. Lyon, BR, May, JW, Skurray, RA. Analysis of plasmids in nosocomial strains of multiple-resistant Staphylococcus aureus . Antimicrob Agents Chemother. 1983;23:817–826.CrossRefGoogle Scholar
10. Boyce, JM. Increasing prevalence of methicillin-resistant Staphylococcus aureus in the United States. Infect Control Hosp Epidemiol. 1990;11:639–642.CrossRefGoogle ScholarPubMed
11. Panlilio, AL, Culver, DH, Gaynes, RP, et al. Methicillin-resistant Staphylococcus aureus in U.S. hospitals, 19751991. Infect Control Hosp Epidemiol. 1992;13:582–586.Google ScholarPubMed
12. Storch, GA, Radclii, JL, Meyer, PL, Hinrichs, JH. Methicillin-resistant Staphylococcus aureus in a nursing home. Infect Control. 1987;8:24–29.CrossRefGoogle ScholarPubMed
13. Thomas, JC, Bridge, J, Waterman, S, Vogt, J, Kilman, L, Hancock, G. Transmission and control of methicillin-resistant Staphylococcus aureus in a skilled nursing facility. Infect Control Hosp Epidemiol. 1989;10:106–110.CrossRefGoogle Scholar
14. Hsu, CCS, Macaluso, CP, Special, L, Hubble, RH. High rate of methicillin resistance of Staphylococcus aureus isolated from hospitalized nursing home patients. Arch Intern Med. 1988;148:569–570.CrossRefGoogle ScholarPubMed
15. Budnick, LD, Schaefler, S. Ciprofloxacin-resistant methicillin-resistant Stabhylococcus aureus in New York health care facilities, 1988. The New York MRSA Study Group. Am J Public Health. 1990;80:810–813.CrossRefGoogle ScholarPubMed
16. Muder, RR, Brennen, C, Wagener, MM, et al. Methicillin-resistant staphylococcal colonization and infection in a long-term care facility. Ann Intern Med. 1991;114:107–112.CrossRefGoogle ScholarPubMed
17. Strausbaugh, LJ, Jacobson, C, Sewell, DL, Potter, S, Ward, TT. Methicillin-resistant Staphylococcus aureus in extended-care facilities. Infect Control Hosp Epidemiol. 1991;12:36–45.CrossRefGoogle ScholarPubMed
18. Bradley, SF, Terpenning, MS, Ramsey, MA, et al. Methicillin-resistant Staphylococcus aureus: colonization and infection in a long-term care facility. Ann Intern Med. 1991;115:417–422.CrossRefGoogle ScholarPubMed
19. Opal, SM, Mayer, KH, Stenberg, MJ, et al. Frequent acquisition of multiple strains of methicillin-resistant Staphylococcus aureus by healthcare workers in an endemic hospital environment. Infect Control Hosp Epidemiol. 1990;11:479–485.CrossRefGoogle Scholar
20. Matsen, JM, Fenn, JP, Abbott, TM, Saxon, BA, Johnson, CC, Hill, GA. A five-year analysis of antimicrobial susceptibility testing profiles for β-lactam antimicrobials, with inter-hospital and susceptibility method comparisons within a medical school affiliated hospital system. Chemioterapia. 1985;IV:71–77.Google Scholar
21. Jones, RN, Barry, AL, Gardiner, RV, Packer, RR. The prevalence of staphylococcal resistance to penicillinase-resistant penicillins. Diagn Microbiol Infect Dis. 1989;12:385–394.CrossRefGoogle ScholarPubMed
22. Berman, DS, Schaefler, S, Simberkoff, MS, Rahal, JJ. Tourniquets and nosocomial methicillin-resistant Staphylococcus aureus infections. N Engl J Med. 1986;315:514–515.Google ScholarPubMed
23. McManus, AT, Mason, AD Jr McManus, WF, Pruitt, BA Jr What's in a name? Is methicillin-resistant Staphylococcus aureus just another S aureus when treated with vancomycin? Arch Surg. 1989;124:1456–1459.Google Scholar
24. Barrett, SP, Mellor, JA. Living with EMRSA-1. J Hosp Infect. 1990;15:103–106.CrossRefGoogle ScholarPubMed
25. Lacey, RW. Multi-resistant Staphylococcus aureus-a suitable case for inactivity, J Hosp Infect. 1987;9:103–105.CrossRefGoogle ScholarPubMed
26. Combined Working Party. Guidelines for the control of epidemic methicillin-resistant Staphylococcus aureus. Report of a combined workinn party of the Hospital Infection Society and British Society for Antimicrobial Chemotherapy. J Hosp Infect. 1986;7:193–201.Google Scholar
27. Bell, SM. Recommendations for control of the spread of methicillin-resistant Staphylococcus aureus infection based on 18 years' experience in a group of teaching hospitals. Med J Aust. 1982;1:472–474.CrossRefGoogle Scholar
28. Boyce, JM. Should we vigorously try to contain and control MRSA? Infect Control Hosp Epidemiol. 1991;12:46–54.CrossRefGoogle Scholar
29. Wenzel, RP, Nettleman, MD, Jones, RN, Pfaller, MA. Methicillin-resistant Staphylococcus aureus: implications for the 1990s and effective control measures. Am J Med. 1991;91(suppl 3B):221S–227S.CrossRefGoogle ScholarPubMed
30. Nettleman, MD, Tiilla, A, Fredrickson, M, Pfaller, M. Assigning responsibility: using feedback to achieve sustained control of methicillin-resistant Staphylococcus aureus . Am J Med. 1991;91(suppl 3B):228S–232S.CrossRefGoogle ScholarPubMed
31. Cohen, SH, Morita, MM, Bradford, M. A seven-year experience with methicillin-resistant Staphylococcus aureus . Am J Med. 1991;91(suppl 3B):233S–237S.CrossRefGoogle ScholarPubMed
32. Rahal, JJ. Resistant staphylococcal infection. Ann Intern Med. 1991;114:911.CrossRefGoogle Scholar
33. Bennett, ME. Thurn, TR Klicker, R. O'Boyle Williams, C. Weiler, M. Recomendations ‘from a Minnesota task force ‘for the management of persons with methicillin-resistant Staphylococcus aureus . Am J Infect Control. 1992;20:42–48.CrossRefGoogle Scholar
34. Chambers, HE Methicillin-resistant staphylococci. Clin Microbiol Rev. 1988;1:173–186.Google ScholarPubMed
35. Lyon, BR, Skurray, R. Antimicrobial resistance of Staphylococcus aureus: genetic basis. Microbiol Rev. 1987;51:88–134.CrossRefGoogle ScholarPubMed
36. Beck, WD, Berger-Bachi, B, Kayser, FH. Additional DNA in methicillin-resistant Staphylococcus aureus and molecular cloning of mec-specific DNA. J Bucteriol. 1986;165:373–378.Google ScholarPubMed
37. Komblum, J, Hartman, BJ, Novick, RP, Tomasz, A. Conversion of a homogeneously methicillin-resistant strain of Staphylococcus aureus to heterogeneous resistance by Tn551-mediated insertional inactivation. Eur J Clin Microbiol. 1986;5:714–718.CrossRefGoogle Scholar
38. DeLencastre, H, SaFigueiredo, AM. Urban, C, Rahal, J, Tomasz, A Multiple mechanisms of methiciilin resistance and improved methods for detection in clinical isolates of Stabhylococcus aureus . Antimicrob Agents Chemother. 1991;35:632–639.CrossRefGoogle Scholar
39. Tesch, W, Ryffel, C, Strassle, A, Kayser, FH, Berger-Bachi, B. Evidence of a novel staphylococcal mecencoded element (mecR) controlling expression of penicillin-binding protein 2′. Antimicrob Agents Chemother. 1990;34:1703–1706.CrossRefGoogle ScholarPubMed
40. Maidhof, H, Reinicke, B, Blumel e Berger-Bachi, B, Labischinski, H. femA, which encodes a factor essential for expression of methicillin resistance, affects glycine content of peptidoglycan in methicillin-resistant and methicillin-susceptible Staphylococcus aureus strains. J Bacteriol. 1991;173:3507–3513.CrossRefGoogle ScholarPubMed
41. Hiramatsu, K, Suzuki, E, Takayama, H, Katayama, Y, Yokota, T. Role of penicillinase plasmids in the stability of the mecA gene in methicillin-resistant Stuphylococcusaureus . Antimicrob Agents Chemother. 1990;34:600–604.Google Scholar
42. Ryffel, C, Kayser, FH, Berger-Bachi, B. Correlation between regulation of mecA transcription and expression of methicillin resistance in staphylococci. Antimicrob Agent Chemother. 1992;36:25–31.CrossRefGoogle ScholarPubMed
43. Crossley, K, Loesch, D, Landesman, B, Mead, K, Chern, M, Strate, R. An outbreak of infections caused by strains of Staphylococcus aureus resistant to methicillin and aminoglycosides. I. Clinical studies. J Infect Dis. 1979;139:275–279.Google ScholarPubMed
44. Peacock, JE Jr Marsik, FJ, Wenzel, RP. Methicillin-resistant Staphylococcus uureus: introduction and spread within a hospital. Ann Intern Med. 1980;93:526–532.CrossRefGoogle ScholarPubMed
45. Sorrell, TC, Packham, DR, Shanker, S, Foldes, M, Munro, R. Vancomycin therapy for methicillin-resistant Staphylococcus aureus . Ann Intern Med. 1982;97:344–350.Google ScholarPubMed
46. Boyce, JM, Landry, M, Deetz, TR, DuPont, HL. Epidemiologic studies of an outbreak of nosocomial methicillin-resistant Staphylococcus aureus infections. Infect Control. 1981;2:110–116.CrossRefGoogle ScholarPubMed
47. Lewis, E, Saravolatz, LD. Comparison of methicillin-resistant and methicillin-sensitive Staphylococcus aureus bacteremia. Am J Infect Control. 1985;13:109–114.Google ScholarPubMed
48. Law, MR, Gill, ON. Hospital-acquired infection with methicillin-resistant and methicillin-sensitive staphylococci. Epidemiol Infect. 1988;101:623–629.CrossRefGoogle ScholarPubMed
49. French, GL, Cheng, AF, Ling, JM, MO, P, Donnan, S. Hong Kong strains of methicillin-resistant and methicillin-sensitive Stuphylococcusuureus have similarvirulence. J Hosp Infect. 1990;15:117–125.CrossRefGoogle Scholar
50. Peacock, JE Jr Moorman, DR, Wenzel, RP, Mandell, GL. Methicillin-resistant Staphylococcus aureus: microbiologic characteristics, antimicrobial susceptibilities, and assessment of virulence of an epidemic. J Infect Dis. 1981;144:575–582.CrossRefGoogle ScholarPubMed
51. Duckworth, GJ, Jordens, JZ. Adherence and survival properties of an epidemic methicillin-resistant strain of Stuphylococcus aureus compared with those of methicillin-sensitive strains. J Med Microbiol. 1990;32:195–200.CrossRefGoogle ScholarPubMed
52. Jordens, JZ, Duckworth, GJ, Williams, RJ. Production of virulence factors by epidemic: methicillin-resistant Staphylococcus aureus in vitro. J Med Microbiol. 1989;30:245–252.CrossRefGoogle ScholarPubMed
53. Shanson, DC. Antibiotic-resistant Staphylococcus aureus . J Hosp Infect. 1981;2:11–36.CrossRefGoogle ScholarPubMed
54. Pavillard, R, Harvey, K, Douglas, D, et al. Epidemic of hospital-acquired infection due to methicillin-resistant Staphylococcus aureus in major Victorian hospitals. Med J Aust. 1982;1:451–454.CrossRefGoogle ScholarPubMed
55. Townsend, DE, Ashdown, N, Annear, DI, Pearman, JW, Grubb, WB. Genetic analysis of methicillin-resistant Staphylococcus aureus from a western Australian hospital. J Hosp Infect. 1984;5:417–424.Google ScholarPubMed
56. Townsend, DE, Ashdown, N, Bradley, JM, Pearman, JW, Grubb, WB. ‘Australian’ methicillin-resistant Staphylococcus aureus in a London hospital. Med J Aust. 1984;141:339–340.Google Scholar
57. Lyon, BR, Iuorio, JL, May, JW, Skurray, RA. Molecular epidemiology of multiresistant Staphylococcus aureus in Australian hospitals. J Med Microbiol. 1984;17:79–89.CrossRefGoogle ScholarPubMed
58. McDougal, LK, Thornsberry, C. The role of p-lactamase in staphylococcal resistance to penicillinase-resistant penicillins and cephalosporins. J Clin Microbiol. 1986;23:832–839.Google Scholar
59. McMurray, LW, Kemodle, DS, Barg, NL. Characterization of a widespread strain of methicillin-susceptible Staphylococcus aureus associated with nosocomial infections. J Infect Dis. 1990;162:759–762.CrossRefGoogle ScholarPubMed
60. Montanari, ME: Tonin, E, Biavasco, E Varaldo, PE. Further characterization of borderline methicillin-resistant Staphylococcus aureus and analysis of penicillin-binding proteins. Antimicrob Agents Chemother. 1990;34:911–913.CrossRefGoogle ScholarPubMed
61. Barg, N, Chambers, H, Kernodle, D. Borderline susceptibility to antistaphylococcal penicillins is not conferred exclusively by the hyperproduction of β-lactamase. Antimicrob Agents Chemother. 1991;35:1975–1979.CrossRefGoogle Scholar
62. Gerberding, JL, Miick, C, Liu, HH, Chambers, HE Comparison of conventional susceptibility tests with direct detection of penicillin-binding protein 2a in borderline oxacillin-resistant strains of Staphylococcus aureus . Antimicrob Agents Chemother. 1991;35:2574–2579.CrossRefGoogle ScholarPubMed
63. Tomasz, A, Drugeon, HB, de Lencastre, HM, Jabes, D, McDougall, L, Bille, J. New mechanism for methicillin resistance in Stuphylococcus aureus: clinical isolates that lack the penicillin-binding protein 2a gene and contain normal penicillin-binding proteins with modified penicillin-binding capacity, Antimicrob Agents Chemother. 1989;33:1869–1874.CrossRefGoogle ScholarPubMed
64. Massanari, RM, Pfaller, MA, Wakefield, DS, et al. Implications of acquired oxacillin resistance in the management and control of Staphylococcus aureus infections. J Infect Dis. 1988;158:702–709.CrossRefGoogle ScholarPubMed
65. Chambers, HE Archer, G, Matsuhashi, M. Low-level methicillin resistance in strains of Staphylococcus uureus. Antimicrob Agents Chemother. 1989;33:424–428.CrossRefGoogle Scholar
66. Thauvin-Eliopoulos, C, Rice, LB, Eliopoulos, GM, Moellering, RC Jr Efficacy of oxacillin and ampicillin-sulbactam combination in experimental endocarditis caused by β-lactamase-hyperproducing Staphylococcus aureus . Antimicrob Agents Chemother. 1990;34:728–732.Google ScholarPubMed
67. Sabath, LD. Chemical and physical factors intluencing methicillin resistance of Staphylococcus aureus and Stuphylococcus epidermidis . J Antimicrob Chemother. 1977;3(suppl C):47–51.CrossRefGoogle ScholarPubMed
68. Boyce, JM, Lytle, LS, Walsh, DA Detection of methicillin-resistant Stuphylococcus uureus by microdilution and disk elution susceptibility systems. J Clin Microbiol. 1984;20:1068–1075.CrossRefGoogle ScholarPubMed
69. Hansen, SL, Freedy, PK. Variation in the abilities of automated, commercial, and reference methods to detect methicillin-resistant (heteroresistant) Staphylococcus uureus . J Clin Microbiol. 1984;20:494–499.CrossRefGoogle Scholar
70. Jorgensen, JH. Mechanisms of methicillin resistance in Staphylococcus aureus and methods for laboratory detection, Infect Control Hosp Epidemiol. 1991;12:14–19.CrossRefGoogle ScholarPubMed
71. Archer, GL, Pennell, E. Detection of methicillin resistance in staphylococci by using a DNA probe. Antimicrob Agents Chemother. 1990;34:1720–1724.CrossRefGoogle ScholarPubMed
72. Ligozzi, M, Rossolini, GM, Tonin, EA, Fontana, R. Nonradioactive DNA probe for detection of gene for methicillin resistance in Staphylococcusaureus . Antimicrob Agents Chemother. 1991;35:575–578.CrossRefGoogle Scholar
73. Murakami, K, Minamide, W, Wada, K, Nakamura, E, Teraoka, H, Watanabe, S. Identification of methicillin-resistant strains of staphylococci by polymerase chain reaction. J Clin Microbiol. 1991;29:2240–2244.CrossRefGoogle ScholarPubMed
74. Thornsberry, C, McDougal, LK. Successful use of broth microdilution in susceptibility tests for methicillin-resistant (heter-oresistant) staphylococci. J Clin Microbiol. 1983;18:1084–1091.CrossRefGoogle ScholarPubMed
75. Boyce, JM. Reevaluation of the ability of the standardized disk diffusion test to detect methicillin-resistant strains of Staphylococcus aureus . J Clin Microbiol. 1984;19:813–817.CrossRefGoogle ScholarPubMed
76. National Committee for Clinical Laboratory Standards. Performance Standards for Antimicrobial Disk Susceptibility Tests. Approved Standard M2-A3. Villanova. Pa: National Committee for Clinical Laboratory Standards; 1984.Google Scholar
77. National Committee for Clinical Laboratory Standards. Methods for Dilution Antimicrobial Susceptibility Tests for Bacteria That Grow Aerobically. Approved Standard M7-A. Villanova, Pa: National Committee for Clinical Laboratory Standards; 1985.Google Scholar
78. Boyce, JM, Potter-Bynoe, G, Opal, SM, Medeiros, AA Common source outbreak of methicillin-resistant S aureus associated with respiratory therapy and nursing personnel. Presented at the 2nd Annual Meeting of the Society for Hospital Epidemiology of America: April 12-14. 1992: Baltimore. Md.Google Scholar
79. Mulligan, ME, Arbeit, RD. Epidemiologic and clinical utility of typing systems for differentiating among strains of methicillii-resistant Staphylococcus aureus . Infect Control Hosp Epidemiol. 1991;12:20–28.CrossRefGoogle ScholarPubMed
80. Archer, GL, Mayhall, CG. Comparison of epidemiological markers used in the investigation of an outbreak of methicillin-resistant Staphylococcus aureus infections. J Clin Microbiol. 1983;18:395–399.CrossRefGoogle ScholarPubMed
81. Mulligan, ME, Kwok, RY, Citron, DM, John, JF Jr Smith, PB. Immunoblots, antimicrobial resistance, and bacteriophage typing of oxacillin-resistant Staphylococcus uureus. J Clin Microbiol. 1988;26:2395–2401.CrossRefGoogle Scholar
82. Gillespie, MT, Lyon, BR, Skurray, RA. Typing of methicillin-resistant Staphylococcus aureus by antibiotic resistance phenotypes. J Med Microbiol. 1990;31:57–64.CrossRefGoogle ScholarPubMed
83. Linnemann, CC Jr, Moore, P, Staneck, JL, Pfaller, MA. Reemergence of epidemic methicillin-resistant Staphylococcus aureus in a general hospital associated with changing staphylococcal strains. Am J Med. 1991;91(suppl 3B):238S–244S.CrossRefGoogle Scholar
84. Blair, JE. Williams, REO. Phage typing of staohylococci. Bull WHO. 1961;24:771–784.Google Scholar
85. Cristino, JA, Pereira, AT. Plasmid analysis of 219 methicillin-resistant Staphylococcus aureus strains with uncommon profiles isolated in Lisbon. J Hosp Infect. 1989;13:133–141.CrossRefGoogle ScholarPubMed
86. Bouvet, A, Foumier, JM, Audurier, A, Branger, C, Orsoni, A, Girard, C. Epidemiological markers for epidemic strain and carrier isolates in an outbreak of nosocomial oxacillin-resistant Staphylococcus aureus . J Clin Microbiol. 1990;28:1338–1341.CrossRefGoogle Scholar
87. Branger, C, Goullet, P, Boutonnier, A, Fournier, JM. Correlation between esterase electrophoretic types and capsular polysaccharide types 5 and 8 among methicillin-susceptible and methicillin-resistant strains of Staphylococcus uureus. J Clin Microbiol. 1990;28:150–151.CrossRefGoogle Scholar
88. Gaston, MA, Duff, PS, Naidoo, J, et al. Evaluation of electrophoretic methods for typing methicillin-resistant Staphylococcus aureus . I Med Microbiol. 1988;26:189–197.Google ScholarPubMed
89. Costas, M, Cookson, BD, Talsania, HG, Owen, RJ. Numerical analysis of electmphoretic protein patterns of methicillin-resistant strains of Staphylococcus aureus . J Clin Microbiol. 1989;27:2574–2581.CrossRefGoogle ScholarPubMed
90. Lee, W, Bumie, JP. Fingerprinting methicillin-resistant Staphylococcus aureus by the immunoblot technique. J Med Microbiol. 1988;25:261–268.CrossRefGoogle ScholarPubMed
91. Bumie, JP, Matthews, RC, Lee, W, Murdoch, D. A comparison of immunoblot and DNA restriction patterns in characterising methicillin-resistant isolates of Staphylococcus aureus . J Med Microbiol. 1989;29:255–261.Google Scholar
92. Coia, JE, Thomson-Carter, E Baird, D, Platt, DJ. Characterisation of methicillin-resistant Staphylococcus uureus by biotyping, immunoblotting and restriction enzyme fragmentation patterns J Med Microbiol. 1990;31:125–132.CrossRefGoogle ScholarPubMed
93. Gillespie, MT, Skurray, RA. Plasmids in multiresistant Staphylococcus aureus . Microbiol Sci. 1986;3:53–58.Google ScholarPubMed
94. Nicolle, LE, Bialkowska-Hobrzanska, H, Romance, L, Harry, VS, Parker, S. Clonal diversity of methicillin-resistant Staphylococcus aureus in an acute-care institution. Infect Control Hosp Epidemiol. 1992;13:33–37.Google Scholar
95. Bigelow, N, Ng, LK, Robson, HG, Dillon, JR. Strategies for molecular characterisation of methicillin- and gentamicin-resistant Staphylococcus aureus in a Canadian nosocomial outbreak. J Med Microbiol. 1989;30:51–58.CrossRefGoogle Scholar
96. Zuccarelli, AI, Roy, I, Harding, GP, Couperus, JJ. Diversity and stability of restriction enzyme profiles of plasmid DNA from methicillin-resistant Staphylococcus aureus . J Clin Microbiol. 1990;28:97–102.CrossRefGoogle ScholarPubMed
97. Hartstein, AI, Morthland, VH, Eng, S, Archer, GL, Schoenknecht, FD, Rashad, AL. Restriction enzyme analysis of plasmid DNA and bacteriophage typing of paired Staphylococcus aureus blood culture isolates. J Clin Microbiol. 1989;27:1874–1879.CrossRefGoogle ScholarPubMed
98. Doebbeling, BN, Pfaller, MA, Hollis, RJ, et al. Restriction endonuclease analysis of Staphylococcus uureus plasmid DNA from three continents. Eur J Clin Microbiol Infect Dis. 1992;11:4–8.CrossRefGoogle ScholarPubMed
99. Jordens, JZ, Hall, LM. Characterization of methicillin-resistant Staphylococcus uureus isolates by restriction endonuclease digestion of chromosomal DNA J Med Microbiol. 1988;27:117–123.CrossRefGoogle ScholarPubMed
100. Goering, RV, Duensing, TD. Rapid field inversion gel electronhoresis in combination with an rRNA gene probe in the epidemiologic evaluation of staphylococci. J Clin Microbiol. 1990;28:426–429.CrossRefGoogle ScholarPubMed
101. Wei, M-Q, Wang, E Grubb, WB. Use of contour-clamped homogeneous electric field (CHEF) electrophoresis to type methicillin-resistant Staphylococcus aureus . J Med Microbiol. 1992;36:172–176.CrossRefGoogle ScholarPubMed
102. Hadom, K, Lenz, W, Kayser, FH, Shalit, I, Krasemann, C. Use of a ribosomal RNA gene probe for the epidemiological study of methicillin and ciprofloxacin resistant Staphylococcus aureus . Eur J Clin Microbiol Infect Dis. 19909649653.Google Scholar
103. Monzon-Moreno, C, Aubert, S, Morvan, A, ElSohl, N. Usefulness of three probes in typing isolates of methicillin-resistant Stuphylococcus aureus (MRSA). J Med Microbiol. 1991;35:80–88.CrossRefGoogle ScholarPubMed
104. Blumberg, HM, Rimland, D, Kiehlbauch, JA, Terry, PM, Wachsmuth, IK. Epidemiologic typing of Staphylococcus uureus by DNA restriction fragment length polymorphisms of rRNA genes: Elucidation of the clonal nature of a group of bacteriophagenontypeable, ciprofloxacin-resistant, methicillin-susceptible S aureus isolates. J Clin Microbiol. 1992;30:362–369.CrossRefGoogle ScholarPubMed
105. Storrs, MJ, Courvalin, P, Foster, TJ. Genetic analysis of gentamicin resistance in methicillin- and gentamicin-resistant strains of Staphylococcus aureus isolated in Dublin hospitals. Antimicrob Agents Chemother. 1988;32:1174–1181.CrossRefGoogle ScholarPubMed
106. Jordens, JZ, Hall, LM. Chromosomally-encoded gentamicin resistance in ‘epidemic’ methicillin-resistant Staphylococcus uureus: detection with a synthetic oligonucleotide probe. J Antimicrob Chemother. 1989;23:327–334.CrossRefGoogle ScholarPubMed
107. Linnemann, CC Jr Mason, M, Moore, P, Korfhagen, TR, Staneck, JL. Methicillin-resistant Staphylococcus aureus: experience in a general hospital over four years. Am J Epidemiol. 1982;115:941–950.CrossRefGoogle Scholar
108. Saroglou, G, Cromer, M, Bisno, AL. Methicillin-resistant Stuphylococcus aureus: interstate spread of nosocomial infections with emergence of gentamicin-methicillin-resistant strains. Infect Control. 1980;1:81–89.CrossRefGoogle ScholarPubMed
109. Ward, TT, Winn, RE, Hartstein, AI, Sewell, DL. Observations relating to an inter-hospital outbreak of methicillin-resistant Staphylococcus aureus: role of antimicrobial therapy in infection control. Infect Control. 1981;2:453–459.Google Scholar
110. Shanson, DC, McSwiggan, DA. Operating theatre acquired infection with a gentamicin-resistant strain of Staphylococcus aureus: outbreak in two hospitals attributable to one surgeon. J Hosp Infect. 1980;1:171–172.CrossRefGoogle ScholarPubMed
111. Reboli, AC, John, JF Jr Platt, CG, Cantey, JR. Methicillin-resistant Staphylococcus aureus outbreak at a Veterans Affairs Medical Center: importance of carriage of the organism by hospital personnel. Infect Control Hosp Epidemiol. 1990;11:291–296.CrossRefGoogle Scholar
112. McHenry, MC, Gavan, TL, Farmer, RG, Evarts, CM. Infection due to methicillin-resistant Staphylococcus uureus . Cleve Clin Q. 1969;36:9–16.Google Scholar
113. Humphreys, H, Carroll, JD, Keane, CT, Cafferkey, MT Pomeroy, HM, Coleman, DC. Importation of methicillin-resistant Staphylococcus aureus from Baghdad to Dublin and subsequent nosocomial spread. J Hosp Infect. 1990;15:127–135.Google ScholarPubMed
114. Rosdahl, VT, Knudsen, AM. The decline of methicillin-resistance among Danish Staphylococcus uureus strains. Infect Control Hosp Epidemiol. 1991;12:83–88.CrossRefGoogle ScholarPubMed
115. Thompson, RL, Cabezudo, I, Wenzel, RP. Epidemiology of nosocomial infections caused by methicillin-resistant Staphylococcus uureus . Ann Intern Med. 1982;97:309–317.CrossRefGoogle Scholar
116. McNeil, JJ, Proudfoot, AD, Tosolini, FA, et al. Methicillin-resistant Staphyococcus aureus in an Australian teaching hospital. J Hosp Infect. 1984;5:18–28.Google Scholar
117. Saravolatz, LD, Pohlod, DJ, Arking, LM. Community-acquired methicillin-resistant Staphylococcus aureus infections: a new source for nosocomial outbreaks. Ann Intern Med. 1982;97:325–329.CrossRefGoogle ScholarPubMed
118. Boyce, JM, White, RL, Spruill, EY. Impact of methicillii-resistant Staphylococcus aureus on the incidence of nosocomial staphylococcal infections. J Infect Dis. 1983;148:763.CrossRefGoogle ScholarPubMed
119. Boyce, JM. Methicillin-resistant Staphylococcus uureus. Detection, epidemiology, and control measures. Infect Dis Clin North Am. 1989;3:901–913.Google ScholarPubMed
120. Hsu, CCS. Serial survey of methicillin-resistant Staphylococcus uureus nasal carriage among residents in a nursing home. Infect Control Hosp Epidemiol. 1991;12:416–421.Google ScholarPubMed
121. Cederna, JE, Terpenning, MS, Ensberg, M, Bradley, SE Kauffman, CA. Staphylococcus aureus nasal colonization in a nursing home: eradication with mupirocin. Infect Control Hosp Epidemiol. 1990;11:13–16.CrossRefGoogle Scholar
122. Crossley, K, Landesman, B, Zaske, D. An outbreak of infections caused by strains of Staphylococcus uureus resistant to methicillin and aminoglycosides, II: epidemiologic studies. J Infect Dis. 1979;139:280–287.CrossRefGoogle ScholarPubMed
123. Cookson, B, Peters, B, Webster, M, Phillips, I, Rahman, M, Noble, W. Staff carriage of epidemic methicillin-resistant Staphylococcus uureus. J Clin Microbiol. 1989;27:1471–1476.CrossRefGoogle Scholar
124. Klimek, JJ, Marsik, FJ, Bartlett, RC, Weir, B, Shea, P, Quintiliani, R. Clinical, epidemiologic and bacteriologic observations of an outbreak of methicillin-resistant Staphylococcus uureus at a large community hospital. Am J Med. 1976;61:340–345.CrossRefGoogle Scholar
125. Arnow, PM, Allyn, PA, Nichols, EM, Hill, DL, Pezzlo, M, Bartlett, RH. Control of methicillin-resistant Staphylococcus uureus in a burn unit: role of nurse staffing. J Trauma. 1982;22:954–959.CrossRefGoogle Scholar
126. Coovadia, YM. Bhana, RH. Tohnson, AP. Haffeiee, I. Marples, RR. A laboratory-confirmed outbreak of rifampicm-methicillin resistant Staphylococcus aureus (RMRSA) in a newborn nursery. J Hosp Inject. 1989;14:303–312.CrossRefGoogle Scholar
127. Locksley, RM, Cohen, ML, Quinn, TC, et al. Multiply antibiotic-resistant Staphylococcus uureus: introduction, transmission, and evolution of nosocomial infection. Ann Intern Med. 1982;97:317–324.Google ScholarPubMed
128. Gaynes, R, Marosok, R, Mowry-Hanley, J, et al. Mediastinitis following coronary artery bypass surgery: A 3-year review. J Infect Dis. 1991;163:117–121.CrossRefGoogle ScholarPubMed
129. Alvarez, S, Shell, C, Gage, K, et al. An outbreak of methicillin-resistant Staphylococcus uureus eradicated from a large teaching hospital. Am J Infect Control. 1985;13:115–121.CrossRefGoogle ScholarPubMed
130. Davies, EA, Emmerson, AM, Hogg, GM, Patterson, ME Shields, MD. An outbreak of infection with a methicillin-resistant Staphylococcus uureus in a special care baby unit: value of topical mupirocin and of traditional methods of infection control. J Hosp Infect. 1987;10:120–128.CrossRefGoogle Scholar
131. Ellison, RI III Judson, FN, Peterson, LC, Cohn, DL, Ehret, JM. Oral rifampin and trimethoprim/sulfamethoxazole therapy in asymptomatic carriers of methicillin-resistant Staphylococcus uureus infections . West J Med. 1984;140:735–740.Google ScholarPubMed
132. Rhinehart, E, Shlaes, DM, Keys, TF, et al. Nosocomial clonal dissemination of methicillin-resistant Staphylococcus uureus. Elucidation by plasmid analysis. Arch Intern Med. 1987;147:521–524.Google ScholarPubMed
133. Shanson, DC, Johnstone, D, Midgley, J. Control of a hospital outbreak of methicillin-resistant Staphylococcus aureus infections: value of an isolation unit. J Hosp Infect. 1985;6:285–292.CrossRefGoogle ScholarPubMed
134. Bacon, AE, Jorgensen, KA, Wilson, KH, Kauffman, CA. Emergence of nosocomial methicillin-resistant Staphylococcus uureus and therapy of colonized personnel during a hospital-wide outbreak. Infect Control. 1987;8:145–150.CrossRefGoogle ScholarPubMed
135. Boyce, JM, White, RL, Causey, WA Lockwood, WR. Burn units as a source of methicillin-resistant Staphylococcus aureus infections. JAMA. 1983;249:2803–2807.Google ScholarPubMed
136. Bradley, JM, Noone, P, Townsend, DE, Grubb, WB. Methicillin-resistant Staphylococcus uureus in a London hospital. Lancet. 1985;i:1493–1495.CrossRefGoogle Scholar
137. Hill, RL, Duckworth, GJ, Casewell, MW. Elimination of nasal carriage of methicillin-resistant Staphylococcus uureus with mupirocin during a hospital outbreak. J Antimicrob Chemother. 1988;22:377–384.CrossRefGoogle ScholarPubMed
138. Bitar, CM, Mayhall, CG, Lamb Veterans, Affairs, Bradshaw, TJ, Spadora, AC, Dalton, HP Outbreak due to methicillin- and rifampin-resistant Staphylococcus uureus: epidemiology and eradication of the resistant strain from the hospital. Infect Control. 1987;8:15–23.CrossRefGoogle ScholarPubMed
139. Craven, DE, Reed, C, Kollisch, N, et al. A large outbreak of infections caused by a strain of Stuphylococcus uureus resistant to oxacillin and aminoglycosides. Am J Med. 1981;71:53–58.CrossRefGoogle ScholarPubMed
140. Dacre, J, Emmerson, AM, Jenner, EA. Gentamicin-methicillin-resistant Staphylococcus uureus: epidemiology and containment of an outbreak. J Hosp Infect. 1986;7:130–136.CrossRefGoogle ScholarPubMed
141. Hill, SE Ferguson, D. Multiply-resistant Staphylococcus uureus (bacteriophage type 90) in a special care baby unit. J Hosp Infect. 1984;5:56–62.Google Scholar
142. Lejeune, B, Buzit-Losquin, E Simitzis-Le Flohic, AM, Le Bras, MP, Alii, D. Outbreak of gentamicin-methicillin-resistant Staphylococcus uureus infection in an intensive care unit for children. J Hosp Inject. 1986;7:21–25.CrossRefGoogle Scholar
143. Law, MR, Gill, ON, Turner, A. Methicillin-resistant Staphylococcus uureus: associated morbidity and effectiveness of control measures. Epidemiol Infect. 1988;101:301–309.Google ScholarPubMed
144. Michel, ME Priem, CC. Control at hospital level of infections by methicillin-resistant staphylococci in children. J Hyg. 1971;69:453–460.CrossRefGoogle ScholarPubMed
145. Murray-Leisure, KA, Geib, S, Graceley, D, et al. Control of epidemic methicillin-resistant Staphylococcus uureus . Infect Control Hosp Epidemiol. 1990;11:343–350.CrossRefGoogle Scholar
146. Price, EH, Brain, A, Dickson, JA. An outbreak of infection with a gentamicin and methicillin-resistant Staphylococcus uureus in a neonatal unit. J Hosp Infect. 1980;1:221–228.Google Scholar
147. Rao, N, Jacobs, S, Joyce, L. Cost-effective eradication of an outbreak of methicillin-resistant Staphylococcus aureus in a community teaching hospital. Infect Control Hosp Epidemiol. 1988;9:255–260.CrossRefGoogle Scholar
148. Shanson, DC, Kensit, JC, Duke, R. Outbreak of hospital infection with a strain of Staphylococcus uureus resistant to gentamicin and methicillin. Lancet. 1976;2:1347–1348.CrossRefGoogle ScholarPubMed
149. Tuffnell, DJ, Croton, RS, Hemingway, DM, Hartley, MN, Wake, PN, Garvey, RJP. Methicillin resistant Staphylococcus uureus; the role of antisepsis in the control of an outbreak. J Hosp Infect. 1987;10:255–259.CrossRefGoogle ScholarPubMed
150. Pearman, JW, Christiansen, KJ, Annear, DI, et al. Control of methicillin-resistant Staphylococcus uureus (MRSA) in an Australian metropolitan teaching hospital complex. Med J Aust. 1985;142:103–108.CrossRefGoogle Scholar
151. Wolinsky, E, Lipsitz, PJ, Mortimer, EA Jr Rammelkamp, CH Jr Acquisition of staphylococci by newborns. Direct versus indirect transmission. Lancet. 1960;ii:620–622.Google Scholar
152. Reagan, DR, Doebbeling, BN, Pfaller, MA, et al. Elimination of coincident Staphylococcus uureus nasal and hand carriage with intranasal application of mupirocin calcium ointment. Ann Intern Med. 1991;114:101–106.CrossRefGoogle ScholarPubMed
153. Mortimer, EA Jr Wolinsky, E, Gonzaga, AJ, Rammelkamp, CH Jr. Role of airborne transmission in staphylococcal infections. By Med J. 1966;1:319–322.CrossRefGoogle ScholarPubMed
154. Rutala, WA, Katz, EBS, Sherertz, RJ, Sarubbi, FA Jr. Environmental study of a methicillin-resistant Staphylococcus uureus epidemic in a burn unit. J Clin Microbiol. 1983;18:683–688.CrossRefGoogle Scholar
155. Bartzokas, CA, Paton, JH, Gibson, ME Graham, E McLaughlin, GA, Croton, RS. Control and eradication of methicillin-resistant Staphylococcus aureus on a surgical unit. N Engl J Med. 1984;311:1422–1425.CrossRefGoogle ScholarPubMed
156. O'Toole, RD, Drew, WL, Dahlgren, BJ, Beaty, HN. An outbreak of methicillin-resistant Staphylococcus aureus infection. Observations in hospital and nursing home. JAMA. 1970;213:257–262.CrossRefGoogle ScholarPubMed
157. Walsh, TJ, Vlahov, D, Hansen, SL, et al. Prospective microbiologic surveillance in control of nosocomial methicillin-resistant Staphylococcus aureus . Infect Control. 1987;8:7–14.CrossRefGoogle ScholarPubMed
158. Millar, MR. Kevworth, N. Lincoln, C. King, B. Conndon, I? ‘Methicillin-resistant’ Staphylococcus aureus in a regional neonatology unit. J Hosp Infect. 1987;10:187–197.CrossRefGoogle Scholar
159. Rimland, D. Nosocomial infections with methicillin and tobra-mycin resistant Staphylococcus uureus-implication of physio-therapy in hospital-wide dissemination. Am J Med Sci. 1985;290:91–97.CrossRefGoogle Scholar
160. Widmer, AF, Pfaller, MA, Wenzel, RP. Failure to isolate methicillin-resistant Staphylococcus aureus from stethoscopes in two hospitals with endemic strains. Eur J Clin Microbiol Infect Dis. 1991;10:46.CrossRefGoogle ScholarPubMed
161. Strausbaugh, IJ, Jacobson, C, Sewell, DL, Potter, S, Ward, IT Antimicrobial therapy for methicillin-resistant Staphylococcusaureus colonization in residents and staff of a Veterans Affairs nursing home care unit. Infect Control Hosp Epidemiol. 1992;13:151–159.Google Scholar
162. Duckworth, GJ, Lothian, JL, Williams, JD. Methicillin-resistant Stuphylococcus uureus: report of an outbreak in a London teaching hospital. J Hosp Infect. 1988;11:1–15.CrossRefGoogle Scholar
163. Cafferkey, MT, Hone, R, Keane, CT Sources and outcome for methicillin-resistant Staphylococcus uureus bacteraemia. J Hosp Infect. 1988;11:136–143.CrossRefGoogle ScholarPubMed
164. Boyce, JM. Nosocomial staphylococcal infections. Ann Intern Med. 1981;95:241–242.CrossRefGoogle ScholarPubMed
165. Sahm, DE Kissinger, J, Gilmore, MS, et al. In vitro susceptibility studies of vancomycin-resistant Enterococcus faecalis . Antimicrob Agents Chemother. 1989;33:1588–1591.CrossRefGoogle ScholarPubMed
166. Leclercq, R, Derlot, E, Weber, M, Duval, J, Courvalin, P. Transferable vancomycin and teicoplanin resistance in Enterococcus faecium . Antimicrob Agents Chemother. 1989;33:10–15.CrossRefGoogle ScholarPubMed
167. Uttley, AH, George, RC, Naidoo, J, et al. High-level vancomycin-resistant enterococci causing hospital infections. Epidemiol Infect. 1989;103:173–181.Google ScholarPubMed
168. Kaplan, AH, Gilligan, PH, Facklam, RR. Recovery of resistant enterococci during vancomycin prophylaxis. J Clin Microbiol. 1988;26:1216–1218.Google ScholarPubMed
169. Uttley, AH, Collins, CH, Naidoo, J, George, RC. Vancomycin-resistant enterococci. Lancet. 1988;i:57–58.CrossRefGoogle Scholar
170. Binnen, E. Lambert-Zechovsky, N. Mariani-Kurkdiian, P, Cezard, JP, Navarro, J. Bacteremia caused by a vancomycin-resistant Enterococcus . Pediatr Infect Dis J. 1989;8:475–476.Google Scholar
171. Nicas, TI, Cole, CT, Preston, DA, Schabel, AA, Nagarajan, R. Activity of glycopeptides against vancomycin-resistant gram-positive bacteria. Antimicrob Agents Chemother. 1989;33:1477–1481.CrossRefGoogle ScholarPubMed
172. Ruoff, KL, Kuritzkes, DR, Wolfson, JS, Ferraro, MJ. Vancomycin-resistant gram-positive bacteria isolated from human sources. J Clin Microbiol. 1988;26:2064–2068.CrossRefGoogle ScholarPubMed
173. Schwalbe, RS, Ritz, WJ, Verma, PR, Barranco, EA, Gilligan, PH. Selection for vancomycin resistance in clinical isolates of Staphylococcus huemotyticus . J Infect Dis. 1990;161:45–51.CrossRefGoogle Scholar
174. Karanfil, LV, Murphy, M, Josephson, A, et al. A cluster of vancomycin-resistant Enterococcus fuecium in an intensive care unit. Infect Control Hosp Epidemiol. 1992;13:195–200.CrossRefGoogle Scholar
175. Livomese, LL Jr Dias, S, Samel, C, et al. Hospital-acquired infection with vancomycin-resistant Enterococcus fuecium transmitted by electronic thermometers. Ann Intern Med. 1992;117:112–116.CrossRefGoogle Scholar
176. Combined Working Party. Revised guidelines for the control of epidemic methicillin-resistant Staphylococcus aureus . J Hosp Infect. 1990;16:351–377.Google Scholar
177. Haley, RW. Methicillin-resistant Stuphylococcus aureus: do we just have to live with it? Ann Intern Med. 1991;114:162–164.CrossRefGoogle ScholarPubMed
178. New Zealand Communicable Disease Centre. Guidelines for the control of methicillin-resistant Staphylococcus aureus in New Zealand. Communicable Disease-New Zealand. 1992;92 (Suppl 1):1–18.Google Scholar
179. LaZonby, JG, Starzyk, MJ. Screening method for recovery of methicillin-resistant Staphylococcus aureus from primary plates. J Clin Microbiol. 1986;24:186–188.Google Scholar
180. Rimland, D, Roberson, B. Gastrointestinal carriage of methicillin-resistant Staphylococcus aureus . J Clin Microbiol. 1986;24:137–138.CrossRefGoogle ScholarPubMed
181. Onesko, KM, Wienke, EC. The analysis of the impact of a mild, low-iodine, lotion soap on the reduction of nosocomial methicillin-resistant Staphylococcus aureus: a new opportunity for surveillance by objectives. Infect Control. 1987;8:284–288.CrossRefGoogle ScholarPubMed
182. Reboli, AC, John, JF Jr Levkoff, AH. Epidemic methicillin-gentamicin-resistant Staphylococcus aureus in a neonatal intensive care unit. Am J Dis Child. 1989;143:34–39.Google Scholar
183. Hambraeus, A. Studies on transmission of Staphylococcus aureus in an isolation ward for burned patients. J Hyg Camb. 1973;71:171–183.Google Scholar
184. Dunkle, LM, Naqvi, SH, McCallum, R, Lofgren, JP. Eradication of epidemic methicillin-gentamicin-resistant Staphylococcus aureus in an intensive care nursery. Am J Med. 1981;70:455–458.CrossRefGoogle Scholar
185. Spicer, WJ. Three strategies in the control of staphylococci including methicillin-resistant Staphylococcus aureus . J Hosp Infect. 1984;5:45–49.CrossRefGoogle ScholarPubMed
186. Selkon, JB, Stokes, ER, Ingham, HR. The role of an isolation unit in the control of hospital infection with methicillin-resistant staphylococci. J Hosp Infect. 1980;1:41–46.CrossRefGoogle ScholarPubMed
187. Ribner, BS, Landry, MN, Gholson, GL. Strict versus modified isolation for prevention of nosocomial transmission of methicillin-resistant Staphylococcus aureus . Infect Control. 1986;7:317–320.CrossRefGoogle ScholarPubMed
188. Nakashima, AK, Allen, JR, Martonk, WJ, et al. Epidemic bullous impetigo in a nursery due to a nasal carrier of Staphylococcus aureus: role of epidemiology and control measures. Infect Control. 1984;5:326–331.CrossRefGoogle Scholar
189. Richardson, JF, Quoraishi, AHM, Francis, BJ, Marples, RR. Beta-lactamase-negative, methicillin-resistant Staphylococcus aureus in a newborn nursery: report of an outbreak and laboratory investigations. J Hosp Infect. 1990;16:109–121.CrossRefGoogle Scholar
190. Bryan, CS, Wilson, BA, Meade e Sill, LG. Topical antibiotic ointments for staphylococcal nasal carriers: Survey of current practices and comparison of bacitracin and vancomycin ointments. Infect Control. 1980;1:153–156.CrossRefGoogle ScholarPubMed
191. Peterson, L, Quick, J, Jensen, B, et al. Emergence of ciprofloxacin resistance in nosocomial methicillin-resistant Staphylococcus aureus isolates. Resistance during ciprofloxacin plus rifampin therapy for methicillin-resistant S aureus colonization. Arch Intern Med. 1990;150:2151–2155.CrossRefGoogle ScholarPubMed
192. Casewell, MW, Hill, RLR Elimination of nasal carriage of Staphylococcus aureus with mupirocin (“pseudomonic acid”)-a controlled trial . J Antimicrob Chemother. 1986;17:365–372.Google ScholarPubMed
193. Tyzack, R The management of methicillin-resistant Staphylococcus aureus in a major hospital. J Hosp Infect. 1985;6:195–199.CrossRefGoogle Scholar
194. Arathoon, EG, Hamilton, JR, Hench, CE, Stevens, DA Efficacy of short courses of oral novobiocin-rifampin in eradicating carrier state of methicillin-resistant Staphylococcus aureus and in vitro killing studies of clinical isolates. Antimicrob Agents Chemother. 1990;34:1655–1659.Google ScholarPubMed
195. Barrett, SP, The value of nasal mupirocin in containing an outbreak of methicillin-resistant Staphylococcus aureus in an orthopaedic unit. J Hosp Infect. 1990;15:137–142.CrossRefGoogle Scholar
196. Mulligan, ME, Ruane, PJ, Johnston, L, et al. Ciprofloxacin for eradication of methicillin-resistant Staphylococcus aureus colonization. Am J Med. 1987;82(suppl 4A):215–219.Google ScholarPubMed
197. Piercy, EA, Barbaro, D, Luby, JP, Mackowiak, PA. Ciprofloxacin for methicillin-resistant Staphylococcus-aureus infections. Antimicrob Agents Chemother. 1989;33:128–130.CrossRefGoogle ScholarPubMed
198. Blumberg, HM, Rimland, D, Wachsmuth, IK. Rapid development of ciprofloxacin resistance in methicillin-susceptible and resistant Staphylococcus aureus . J Infect Dis. 1991;163:1279–1285.CrossRefGoogle ScholarPubMed
199. Smith, SM. Ene, RHK. Bais, I? Fan-Havard, P. Tecson-Tumang, E Epidemiology of ciprofloxacin resistance among patients with methicillin-resistant Staphylococcus aureus . J Antimicrob Chemother. 1990;26:567–572.CrossRefGoogle ScholarPubMed
200. Rahman, M, Noble, WC, Cookson, B. Mupirocin-resistant Staphylococcus aureus . Lancet. 1987;ii:387.CrossRefGoogle Scholar
201. Smith, GE, Kennedy, CTC. Staphylococcus aureus resistant to mupirocin. J Antimicrob Chemother. 1988;21:141–142.CrossRefGoogle ScholarPubMed
202. Cookson, BD, Lacey, RW, Noble, WC, Reeves, DS, Wise, R, Redhead, RJ. Mupimcin-resistant Staphylococcus aureus . Lancet. 1990;i:1095–1096.CrossRefGoogle Scholar
203. Hudson, I. Mupirocin resistance. Lancet. 1992;i:56.Google Scholar
204. Baird, D, Coia, J. Mupirocin-resistant Staphylococcus aureus . Lancet. 1987;ii:387–388.Google Scholar
205. Slocombe, B, Perry, C. The antimicrobial activitv of munirocin—an update on resistance. J Hosp Infect. 1991;19(suppl B):19–25.CrossRefGoogle Scholar
206. Rahman, M, Noble, WC, Cookson, BD. Transmissible mupirocin-resistance in Staphylococcus aureus . Epidemiol Infect. 1989;102:261–270.CrossRefGoogle ScholarPubMed
207. Kauffman, C, Terpenning, M, He, X, Ramsey, M, Zarins, L, Bradley, S. Use of mupirocin to decrease MRSA colonization in a long-term care facility. Program and Abstracts of the 31st Interscience Conference on Antimicrobia1 Agents and Chemotherapy. Washington, DC: American Society for Microbiology; 1991: Abstr#33:104.Google Scholar
208. Reagan, DR, Dula, RT, Palmer, BH, Gutierrez, CN, Franzus, BF, Sarubbi, FA Control of MRSAin a VAMC with limited resources. Program and Abstracts of the 31st Interscience Conference on Antimicrobial Agents and Chemotherapy. Washington, DC: American Society for Microbiology; 1991;Abstr #31:104.Google Scholar
209. Smith, SM, Eng, RH, Tecson-Tumang, E Ciprofloxacin therapy for methicillin-resistant Staphylococcus aureus infections or colonizations. Antimicrob Agents Chemother. 1989;33:181–184.CrossRefGoogle ScholarPubMed
210. Darouiche, R, Wright, C, Hamill, R, Koza, M, Lewis, D, Markowski, J. Eradication of colonization by methicillin-resistant Staphylococcus aureus by using oral minocycline-rifampin and topical mupirocin. Antimicrob Agents Chemother. 1991;35:1612–1615.CrossRefGoogle ScholarPubMed
211. Goldfarb, S. Tames, GCW. Abolition of staohylococcal cross-infection in a thoracic surgical ward. Br Med J. 1963;1:305–308.CrossRefGoogle Scholar
212. Ransjo, U, Malm, M, Hambraeus, A, Artursson, G, Hedlund, A. Methicillin-resistant Staphylococcus aureus in two bum units: clinical significance and epidemiological control. J Hosp Infect. 1989;13:355–365.CrossRefGoogle Scholar
213. Haley, CE, Marling-Cason, M, Smith, JW, Lyby, JP, Mackowiak, PA Bactericidal activity of antiseptics against methicillin-resistant Staphylococcus aureus . J Clin Microbiol. 1985;21:991–992.CrossRefGoogle ScholarPubMed
214. Kobayashi, H, Tsuzuki, M, Hosobuchi, K. Brief report: bactericidal effects of antiseptics and disinfectants against methicillin-resistant Staphylococcus aureus . Infect Control Hosp Epidemiol. 1989;10:562–564.CrossRefGoogle Scholar
215. Al-Masaudi, SB, Day, MJ, Russell, AD. Sensitivity of methicillin-resistant Staphylococcus aureus strains to some antibiotics, antiseptics and disinfectants. J Appl Bacteriol. 1988;65:329–337.CrossRefGoogle ScholarPubMed
216. Tennent, JM, Lyon, BR, Gillespie, MT, May, JW, Skurray, RA. Cloning and expression of Staphylococcus aureus plasmid-mediated quatemary ammonium resistance in Escherichia coli . Antimicrob Agents Chemother. 1985;27:79–83.Google Scholar