Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-19T21:57:24.426Z Has data issue: false hasContentIssue false
  • English
  • Français

A Comparison of Clinical Virulence of Nosocomially Acquired Methicillin-Resistant and Methicillin-Sensitiye Staphylococcus aureus Infections in a University Hospital

Published online by Cambridge University Press:  21 June 2016

Ronald C. Hershow ,
Walid F. Khayr  and
Nina L. Smith
Ronald C. Hershow*
Affiliation:
School of Medicine, University of Illinois at Chicago, Chicago, Illinois School of Public Health, University of Illinois at Chicago, Chicago, Illinois
Walid F. Khayr
Affiliation:
School of Medicine, University of Illinois at Chicago, Chicago, Illinois
Nina L. Smith
Affiliation:
School of Medicine, University of Illinois at Chicago, Chicago, Illinois
*
University of Illinois at Chicago, School of Public Health, 2121 W. Taylor St., Chicago, IL 60612
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

To compare the clinical virulence of nosocomially acquired methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive S aureus (MSSA) infections in 1989.

Design:

A retrospective comparison of host factors, in-hospital exposures, sites of infections, and outcomes of patients with nosocomial MRSA and MSSA infections.

Setting:

University of Illinois Hospital, Chicago, Illinois.

Participants:

Forty-four adult patients with nosocomial S aureus infections.

Results:

The 22 MRSA-infected and 22 MSSA-infected persons were similar regarding mean age, gender, underlying diseases, and exposure to surgery. Before developing infection, MRSA-infected persons were more likely to have received antibiotics (73% compared with 27%, odds ratio = 7.1, 95% confidence interval [CI95] = 2.0-25.8 p = .003) and to have stayed in the hospital >2 weeks (64% compared with 18%, odds ratio = 7.9, CI95 = 2.0-31.6, p = .002). Bacteremia was the most common presentation in the MRSA and MSSA groups (55% and 59%, respectively). Infectious complications and death were infrequent in both groups.

Conclusions:

MRSA and MSSA strains infect patients with similar demographic features and underlying diseases, but MRSA infections are significantly more common among patients with previous antibiotic therapy and a prolonged preinfection hospital stay. Clinical presentations and outcomes did not differ significantly between the 2 groups. Thus, similar to studies in the early 1980s, our findings do not suggest greater intrinsic virulence of MRSA.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 13 , Issue 10 , October 1992 , pp. 587 - 593
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1992 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Haley, RW, Hightower, AW, Khabbaz, RF, et al. The emergence of methicillin-resistant Staphylococcus aureus infections in United States hospitals. Ann Intern Med. 1982;97:297–308.CrossRefGoogle ScholarPubMed
2. Peacock, JE Jr., Moorman, DR, Wenzel, RP, Mandell, DR. Methicillin-resistant Staphylococcus aureus: microbiologic characteristics, antimicrobial susceptibilities, and assessment of virulence of an epidemic strain. J Infect Dis. 1981;144:575–582.CrossRefGoogle ScholarPubMed
3. Vaudaux, P, Waldvogel, FA. Methicillin-resistant strains of Staphylococcus aureus: relation between exoression of resistance and phagocytosis by polymorphonuclear leukocytes. J Infect Dis. 1982;97:309–317.Google Scholar
4. Coleman, DC, Cafferkey, M, Keane, CT, et al. Mechanisms of pathogenicity of multi-resistant Staphylococcus aureus . J Hosp Infect. 1986;7(suppl A):29–35.CrossRefGoogle ScholarPubMed
5. French, GL, Cheng, AFB, Ling, JML, Mo, P, Donnan, S. Hong Kong strains of methicillin-resistant and methicillin-sensitive Staphylococcus aureus have similar virulence. J Hosp Infect. 1990;15:117–125.CrossRefGoogle ScholarPubMed
6. Ward, TT, Krause, LK. Adherence of methicillin-susceptible versus methicillin-resistant Staphylococcus aureus to epithelial cells In: Program and Abstracts of the 31st Interscience Conference on Antimicrobial Agents and Chemotherapy. Chicago, Ill: American Society for Microbiology; 1991:163.Google Scholar
7. 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
8. Duckworth, GJ, Jordens, JZ. Adherence and survival properties of an epidemic methicillin-resistant strain of Staphylococcus aureus compared with those of methicillin-sensitive strains. J Med Microbiol. 1990;32:195–200.CrossRefGoogle ScholarPubMed
9. 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
10. 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;139:273–279.CrossRefGoogle ScholarPubMed
11. 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
12. Sorrell, TC, Packham, DR, Shanker, S, Foldes, M, Munro, R. Vancomycin therapy for methicillin-resistant Staphylococcus aureus . Ann Intern Med. 1982;97:344–350.CrossRefGoogle ScholarPubMed
13. Grieble, HG, Krause, SL, Pappas, SA, Dicostanzo, MB. The prevalence of high-level methicillin resistance in multiply resis tant hospital staphylococci. Medicine. 1981;60:62–69.CrossRefGoogle Scholar
14. Law, MR, Gill, ON. Hospital-acquired infection with methicillin-resistant and methicillin-sensitive staphylococci. Epidemiol Infect. 1988;101:623–629.CrossRefGoogle ScholarPubMed
15. McManus, AT, Mason, AD, McManus, WE, Pruitt, BA. What's in a name? Is methicillin-resistant Staphylococcus aureus just another S aureus when treated with vancomycin? Arch Surg. 1989;124:1456–1459.CrossRefGoogle Scholar
16. Lewis, E, Saravolatz, LD. Comparison of methicillin-resistant and methicillin-sensitive Staphylococcus aureus bacteremia. Am J Infect Control. 1985;13:109–114.CrossRefGoogle ScholarPubMed
17. 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
18. Gamer, JS, Jarvis, WR, Emori, TG, Horan, TC, Hughes, JM. CDC definitions for nosocomial infections, 1988. Am J Infect Control. 1988;16:128–140.Google Scholar
19. National Committee for Clinical Laboratory Standards. Performance Standards for Antimicrobial Disc Susceptibility lists. 4th ed. M2-A4. Villanova, Pa: National Committee-for Clinical Laboratory Standards; 1990.Google Scholar
20. Schlesselman, JJ. Case-Control Studies. Design, Conduct, Analysis. New York, NY: Oxford University Press; 1982.Google Scholar
21. Brumtitt, W, Hamilton-Miller, J. Methicillin-resistant Staphylococcus aureus . N Engl /Med. 1989;320:1188–1196.CrossRefGoogle Scholar
22. Raviglione, MC, Boyle, JF, Mariuz, P, Pablos-Mendez, A, Cortes, H, Merlo, A. Ciprofloxacin-resistant methicillin-resistant Staphylococcus aureus in an acute care hospital. Antimicrob Agents Chemother. 1990:34:2050–2054.CrossRefGoogle Scholar
23. Klimek, JJ, Marsik, FJ, Bartlett, RC, Weir, B, Shea, P, Quintiliani, R. Clinical, epidemiologic and bacteriologic observations of an outbreak of methicillin-resistant Staphylococcus aureus at a large community hospital. Am J Med. 1976;61:340–345.CrossRefGoogle Scholar
24. Saroglou, 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 ScholarPubMed
25. Winn, RE, Ward, TT, Hartstein, Al, et al. Epidemiological, bacteriological and clinical observations on an interhospital outbreak of nafcillin-resistant Staphylococcus aureus. In: Nelson, JD, Grassi, D, eds. Current Chemotherapy and Infectious Disease. Vol 2. Washington, DC: American Society for Microbiology; 1980:1096–1097.Google Scholar