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Methicillin-resistant Staphylococcus aureus in Veterans Administration Medical Centers

Published online by Cambridge University Press:  02 January 2015

Laurel C. Preheim ,
David Rimland  and
Marvin J. Bittner
Laurel C. Preheim*
Affiliation:
Medical Service, Veterans Administration Medical Center, Creighton University School of Medicine, Omaha, Nebraska
David Rimland
Affiliation:
Medical Service, Veterans Administration Medical Center, Emory University School of Medicine, Atlanta, Georgia
Marvin J. Bittner
Affiliation:
Medical Service, Veterans Administration Medical Center, Creighton University School of Medicine, Omaha, Nebraska
*
Infectious Diseases Section, Veterans Administration Medical Center, 4101 Woolworth Avenue, Omaha, NE 68105
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Abstract

To determine the frequency of isolation of methicillin-resistant Staphylococcus aureus (MRSA) at Veterans Administration Medical Centers, 163 hospitals were surveyed; 137 responded. Between 1975 and 1984, the number of Veterans Administration Medical Centers with known MRSA increased from 3 to 111. This increase was geographically widespread and occurred in hospitals of all sizes. In Veterans Administration Medical Centers, isolation policies for MRSA-infected patients were (% of hospitals using): strict (19%), contact (52%), site-related (28%), no isolation (1%). For patients colonized with MRSA policies were: strict (15%), contact (44%), site-related (35%), and no isolation (6%). Only 41% of Veterans Administration Medical Centers reported discharging known MRSA-colonized patients to nursing homes. Most attempts to eradicate MRSA carriage used trimethoprim-sulfamethoxazole plus rifampin with or without bacitracin ointment; success rates were low. MRSA incidence is increasing at Veterans Administration Medical Centers across the United States. Improved regimens to eliminate MRSA carriage are needed.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 8 , Issue 5 , May 1987 , pp. 191 - 194
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1987

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References

1.Haley, RW, Hightower, AW, Khabbaz, RF, et al: The emergence of methicillin resistant Staphylococcus aureus infections in United States hospitals. Possible role of the house staff-patient transfer circuit. Ann Inlern Med 1982; 97:297–308.CrossRefGoogle ScholarPubMed
2.Boyce, JM, Causey, WA: Increasing occurrence of methicillin-resistant Staphylococcus aureus in the United States. Infect Control 1982; 3:377–383.CrossRefGoogle ScholarPubMed
3.Jarvis, WR, Thornsberry, C, Boyce, J, et al: Methicillin-resistant Staphylococcus aureus at children's hospitals in the United States. Pediatr Infect Dis 1985; 4:651–655.CrossRefGoogle ScholarPubMed
4.Annual Report 1984. US Department of Health and Human Services, Veterans Administration, 1985, pp 9–69.Google Scholar
5.Richmond, AS, Simberkoff, MS, Schaefler, S, et al: Resistance of Staphylococcus aureus to semisynthetic penicillins and cephalothin. J Infect Dis 1977; 135:108–112.CrossRefGoogle ScholarPubMed
6.Grieble, HG, Krause, SL, Pappas, SA, et al: The prevalence of high-level methicillin resistance in multiply resistant hospital staphylococci. Medicine (Baltimore) 1981; 60:62–69.CrossRefGoogle ScholarPubMed
7.Ward, TT, Winn, RE, Hartstein, AI, et al: 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.CrossRefGoogle Scholar
8.Alvarez, S, Shell, C, Gage, K, et al: An outbreak of methicillin-resistant Staphylococcus aureus eradicated from a large teaching hospital. Am J Infect Control 1985; 13:115–121.CrossRefGoogle ScholarPubMed
9.Lentino, JR, Hennein, H, Krause, S, et al: A comparison of pneumonia caused by gentamicin, methicillin-resistant and gentamicin, methicillin-sensitive Staphylococcus aureus: Epidemiologic and clinical studies. Infect Control 1985; 6:267–272.CrossRefGoogle ScholarPubMed
10.Eng, RHK, Smith, SM, Tillem, M, et al: Rifampin resistance. Development during the therapy of methicillin-resistant Staphylococcus aureus infection. Arch Intern Med 1985; 145:146–148.CrossRefGoogle ScholarPubMed
11.Rimland, D: Nosocomial infections with methicillin and tobramycin resistant Staphylococcus aureus—Implication of physiotherapy in hospital-wide dissemination. Am J Med Sci 1985; 290:91–97.CrossRefGoogle ScholarPubMed
12.Aldridge, KE, Janney, A, Sanders, CV, et al: Inter-laboratory variation of anti-biograms of methicillin-resistant and methicillin-susceptible Staphylococcus aureus strains with conventional and commercial testing systems. J Clin Microbiol 1983; 18:1226–1236.CrossRefGoogle Scholar
13.Thornsberry, C, McDougal, LK: Successful use of broth microdilution in susceptibility tests for methicillin-resistant (heteroresistant) staphylococci. J Clin Microbiol 1983; 18:1084–1091.CrossRefGoogle ScholarPubMed
14.Boyce, JM, Lytle, LS, Walsh, DA: Detection of methicillin-resistant Staphylococcus aureus by microdilution and disk elution susceptibility systems. J Clin Microbiol 1984; 20:1068–1075.CrossRefGoogle ScholarPubMed
15.Aldridge, KE: Methicillin-resistant Staphylococcus aureus: Clinical and laboratory features. Infect Control 1985; 6:461–465.CrossRefGoogle ScholarPubMed
16.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
17.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
18.Schaefler, S, Jones, D, Perry, W, et al: Methicillin-resistant Staphylococcus aureus strains in New York City hospitals: Inter-hospital spread of resistant strains of type 88. J Clin Microbiol 1984; 20:536–538.CrossRefGoogle ScholarPubMed
19.Saraglou, G, Cromer, M, Bisno, AL: Methicillin-resistant Staphylococcus aureus: Interstate spread of nosocomial infections with emergence of gentamicin-methicillin resistant strains. Infect Control 1980; 1:81–89.CrossRefGoogle Scholar
20.Boyce, JM, Landry, M, Deetz, TR, et al: Epidemiologie studies of an outbreak of nosocomial methicillin-resistant Staphylococcus aureus infections. Infect Control 1981; 2:110–116.CrossRefGoogle Scholar
21.Longfield, JN, Townsend, TR, Cruess, DF, et al: Methicillin-resistant Staphylococcus aureus: Risk and outcome of colonized vs. infected patients. Infect Control 1985; 6:445–450.CrossRefGoogle ScholarPubMed
22.1984 Summary: National Hospital Discharge Survey, in 1984 Summary: Advance Data from Vital and Health Statistics, US Dept of Health and Human Services publication (PHS) 85-1250. Hyattsville, MD, 1985.Google Scholar
23.Garner, JS, Simmons, BP: Guideline for isolation precautions in hospitals. Infect Control 1983; 4:245–325.Google ScholarPubMed
24.Thompson, RL, Cabezudo, I, Wenzel, RP: Epidemiology of nosocomial infections caused by methicillin-resistant Staphylococcus aureus. Ann Intern Med 1982; 97:309–317.CrossRefGoogle ScholarPubMed
25.Arnow, PM, Allyn, PA, Nichols, EM, et al: Control of methicillin-resistant Staphylococcus aureus in a burn unit: Role of nurse staffing. J Trauma 1982; 22:954–959.CrossRefGoogle Scholar
26.Keane, CT, Cafferkey, MT: Re-emergence of methicillin-resistant Staphylococcus aureus causing severe infection. J Infect 1984; 9:6–16.CrossRefGoogle ScholarPubMed
27.Tyzack, R: The management of methicillin-resistant Staphylococcus aureus in a major hospital. j Hosp Infect 1985; 6(suppl A):195–199.CrossRefGoogle Scholar
28.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
29.Locksley, RM, Cohen, ML, Quinn, TC, et al: Multiply antibiotic-resistant Staphylococcus aureus: Introduction, transmission, and evolution of nosocomial infection. Ann Intern Med 1982; 97:317–324.CrossRefGoogle ScholarPubMed
30.Arroyo, JC, Postic, B: Use of 3 percent hexachlorophene baths to control patient colonization by oxacillin and aminoglycoside-resistant Staphylococcus aureus. Am J Med 1982; 72:112.CrossRefGoogle ScholarPubMed
31.Jones, L, Baggott, JB: Control and elimination of an MRSA outbreak. Med J Aust 1982; 2:480.CrossRefGoogle Scholar
32.Bartzokas, CA, Paton, JH, Gibson, MF, et al: Control and eradication of methicillin-resistant Staphylococcus aureus on a surgical unit. N Engl J Med 1984; 311:1422–1425.CrossRefGoogle ScholarPubMed
33.Ellison, RT, Judson, FN, Peterson, LC, et al: Oral rifampin and trimethoprim/sulfamethoxazole therapy in asymptomatic carriers of methicillin-resistant Staphylococcus aureus infections. West J Med 1984; 140:735–740.Google ScholarPubMed
34.Aeilts, GD, Sapico, FL, Canawati, HN, et al: Methicillin-resistant Staphylococcus aureus colonization and infection in a rehabilitation facility. J Clin Microbiol 1982; 16:218–223.CrossRefGoogle Scholar
35.Hone, R, Keane, CT: Fecal carriage of methicillin-resistant staphylococci. Lancet 1985; 2:445–446.CrossRefGoogle ScholarPubMed
36.Rimland, D, Roberson, B: Gastrointestinal carriage of methicillin-resistant Staphylococcus aureus. J Clin Microbiol 1986; 24:137–138.CrossRefGoogle ScholarPubMed
37.Eng, RHK, Smith, SM, Buccini, FJ, et al: Differences in ability of cell-wall antibiotics to suppress emergence of rifampicin resistance in Staphylococcus aureus. J Antimicrob Chemother 1985; 15:201–207.CrossRefGoogle ScholarPubMed
38.Wenzel, RP: The emergence of methicillin-resistant Staphylococcus aureus. Ann Intern Med 1982; 97:440–441.CrossRefGoogle ScholarPubMed