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Antimicrobial Resistance in Staphylococcus aureus at the University of Chicago Hospitals: A 15-Year Longitudinal Assessment in a Large University-Based Hospital

Published online by Cambridge University Press:  02 January 2015

John B. Seal ,
Beatriz Moreira ,
Cindy D. Bethel  and
Robert S. Daum
John B. Seal
Affiliation:
Department of Pediatrics, Section of Pediatric Infectious Diseases, University of Chicago, Chicago, Illinois
Beatriz Moreira
Affiliation:
Instituto de Microbiologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
Cindy D. Bethel
Affiliation:
Clinical Microbiology Laboratories, University of Chicago Hospitals, Chicago, Illinois
Robert S. Daum*
Affiliation:
Department of Pediatrics, Section of Pediatric Infectious Diseases, University of Chicago, Chicago, Illinois
*
University of Chicago Children's Hospital, MC 6054, 5841 S. Maryland Avenue, Chicago, IL 60637
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Abstract

Objectives:

To describe a longitudinal profile of resistance to beta-lactam antimicrobials among isolates of Staphylococcus aureus at a large university teaching hospital and to evaluate the impact of the methicillin resistance phenotype on resistance trends for non-beta-lactam antimicrobials.

Design:

Retrospective evaluation of antimicrobial susceptibility data for all 17,287 S. aureus isolates obtained from January 1986 through December 2000.

Setting:

The University of Chicago Hospitals, a family of tertiary-care, university-affiliated hospitals in Chicago, Illinois, consisting of 547 adult and pediatric beds.

Results:

The annual rate of resistance to methicillin increased from 13% in 1986 to 28% in 2000 (P < .001) and has not plateaued. For each non-beta-lactam antimicrobial tested, the annual rates of resistance were far higher among methicillinresistant S. aureus (MRSA) isolates than among methicillin-susceptible S. aureus (MSSA) isolates. The annual rates of resistance to the macrolide, lincosamide, and streptogramin (MLS) antimicrobials erythromycin and clindamycin increased among MSSA isolates (P < .01), but remained lower than 20%. Resistance to the MLS antimicrobials was higher among MRSA isolates (higher than 60%), but the annual rate decreased significantly during the study (P < .01).

Conclusion:

The prevalence of methicillin resistance among S. aureus isolates has continued to increase; resistance to non-beta-lactam antimicrobials is far more common among MRSA isolates. Recent decreases in the proportion of MRSA isolates resistant to non-beta-lactam antimicrobials suggest important changes in the epidemiology of this pathogen.

Type
Orginal Articles
Information
Infection Control & Hospital Epidemiology , Volume 24 , Issue 6 , June 2003 , pp. 403 - 408
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2003

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