Macrolide and Clindamycin Resistance in Staphylococcus aureus Isolates and Antibiotic Use in a Veterans Affairs Medical Center

2008 ◽  
Vol 29 (2) ◽  
pp. 180-182 ◽  
Author(s):  
Rohit Modak ◽  
David Ross ◽  
Virginia L. Kan
Keyword(s):  
Staphylococcus Aureus ◽  
Retrospective Analysis ◽  
Medical Center ◽  
Antibiotic Use ◽  
Veterans Affairs ◽  
Inducible Clindamycin Resistance

A retrospective analysis of 13,946 Staphylococcus aureus isolates revealed a stable incidence of isolates that were resistant to both clindamycin and erythromycin, but a significantly increasing incidence of isolates that were susceptible to clindamycin and resistant to erythromycin during 1991-1995, 1996-2000, and 2001-2005. The use of macrolides and clindamycin also increased during 1996-2005. The incidence of S. aureus isolates with inducible clindamycin resistance increased steadily and significantly during the period from August 2004 through December 2005.

Perception vs Reality: Methicillin-Resistant Staphylococcus aureus Carriage Among Healthcare Workers at a Veterans Affairs Medical Center

2015 ◽  
Vol 37 (1) ◽  
pp. 110-112 ◽  
Author(s):  
Nora E. Colburn ◽  
Jennifer Cadnum ◽  
Elizabeth Flannery ◽  
Shelley Chang ◽  
Curtis J. Donskey ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Healthcare Workers ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Medical Center ◽  
Veterans Affairs ◽  
Infect Control Hosp ◽  
Prevalence Study ◽  
Methicillin Resistant ◽  
Knowledge Deficit

In a prevalence study of 209 healthcare workers, 18 (8.6%) and 13 (6.2%) carried methicillin-resistant Staphylococcus aureus in their nares or on their hands, respectively. However, 100 (62%) of 162 workers completing an associated survey believed themselves to be colonized, revealing a knowledge deficit about methicillin-resistant Staphylococcus aureus epidemiology.Infect. Control Hosp. Epidemiol. 2015;37(1):110–112

Excess Costs and Utilization Associated with Methicillin Resistance for Patients with Staphylococcus aureus Infection

2010 ◽  
Vol 31 (4) ◽  
pp. 365-373 ◽  
Author(s):  
Gregory A. Filice ◽  
John A. Nyman ◽  
Catherine Lexau ◽  
Christine H. Lees ◽  
Lindsay A. Bockstedt ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistance ◽  
Medical Center ◽  
Patient Characteristics ◽  
Veterans Affairs ◽  
Department Of Veterans Affairs ◽  
Accounting Systems ◽  
Excess Costs ◽  
Mrsa Infection ◽  
Mssa Infection

Objective.To determine differences in healthcare costs between cases of methicillin-susceptible Staphylococcus aureus (MSSA) infection and methicillin-resistant S. aureus (MRSA) infection in adults.Design.Retrospective study of all cases of S. aureus infection.Setting.Department of Veterans Affairs hospital and associated clinics.Patients.There were 390 patients with MSSA infections and 335 patients with MRSA infections.Methods.We used medical records, accounting systems, and interviews to identify services rendered and costs for Minneapolis Veterans Affairs Medical Center patients with S. aureus infection with onset during the period from January 1, 2004, through June 30, 2006. We used regression analysis to adjust for patient characteristics.Results.Median 6-month unadjusted costs for patients infected with MRSA were $34,657, compared with $15,923 for patients infected with MSSA. Patients with MRSA infection had more comorbidities than patients with MSSA infection (mean Charlson index 4.3 vs 3.2; P < .001). For patients with Charlson indices of 3 or less, mean adjusted 6-month costs derived from multivariate analysis were $51,252 (95% CI, $46,041–$56,464) for MRSA infection and $30,158 (95% CI, $27,092–$33,225) for MSSA infection. For patients with Charlson indices of 4 or more, mean adjusted costs were $84,436 (95% CI, $79,843–$89,029) for MRSA infection and $59,245 (95% CI, $56,016–$62,473) for MSSA infection. Patients with MRSA infection were also more likely to die than were patients with MSSA infection (23.6% vs 11.5%; P < .001). MRSA infection was more likely to involve the lungs, bloodstream, and urinary tract, while MSSA infection was more likely to involve bones or joints; eyes, ears, nose, or throat; surgical sites; and skin or soft tissue (P < .001).Conclusions.Resistance to methicillin in S. aureus was independently associated with increased costs. Effective antimicrobial stewardship and infection prevention programs are needed to prevent these costly infections.

scholarly journals In VitroActivity of Retapamulin and Antimicrobial Susceptibility Patterns in a Longitudinal Collection of Methicillin-Resistant Staphylococcus aureus Isolates from a Veterans Affairs Medical Center

2015 ◽  
Vol 60 (3) ◽  
pp. 1298-1303 ◽  
Author(s):  
Amanda T. Harrington ◽  
Jennifer A. Black ◽  
Jill E. Clarridge
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Agents ◽  
Medical Center ◽  
Alternative Therapy ◽  
Puget Sound ◽  
Veterans Affairs ◽  
Methicillin Resistant ◽  
Vancomycin Mics ◽  
Level Resistance

Mupirocin is a topical antimicrobial used to decolonize patients who carry methicillin-resistantStaphylococcus aureus(MRSA), and the topical agent retapamulin may be a potential alternative therapy. The goal of this study was to determine thein vitroactivity of retapamulin as well as a panel of 15 antimicrobial agents, including mupirocin, for 403 MRSA isolates collected longitudinally from a naive population at the Veterans Affairs Puget Sound Health Care System. The MICs for retapamulin had a unimodal distribution, ranging from 0.008 to 0.5 μg/ml. One isolate had an MIC of >16 μg/ml, was also resistant to clindamycin and erythromycin, and was recovered from the nares of a patient undergoing hemodialysis. Twenty-four isolates (6%) and 11 isolates (3%) demonstrated low-level resistance (MICs of 8 to 64 μg/ml) and high-level resistance (MICs of ≥512 μg/ml), respectively, to mupirocin. Isolates were recovered from 10 patients both before and after mupirocin therapy. Of those, isolates from 2 patients demonstrated MIC changes postmupirocin therapy; in both cases, however, strain typing demonstrated that the pre- and postmupirocin strains were different. A total of 386 isolates (96%) had vancomycin MICs of ≤1.0 μg/ml; 340 isolates (84%) were resistant to levofloxacin, 18 isolates (4.5%) were resistant to trimethoprim-sulfamethoxazole, and 135 isolates (33%) had elevated MICs of 4 μg/ml for linezolid. The baseline levels of resistance were low for mupirocin (9%) and even lower for retapamulin (0.25%) Although the use of mupirocin is currently the standard therapy for decolonization practices, the activity of retapamulin warrants its consideration as an alternative therapy in MRSA decolonization regimens.

scholarly journals Patterns of Constitutive and Inducible Clindamycin Resistance in Staphylococcus aureus Isolated from Clinical Samples by D-test Method, Shiraz, Southwest of Iran

2014 ◽  
Vol 3 (4) ◽  
pp. 216-21
Author(s):  
Mohammad Motamedifar ◽  
Hadi Seddigh Ebrahim Sarai ◽  
Davood Mansury
Keyword(s):  
Staphylococcus Aureus ◽  
Medical Center ◽  
Cross Sectional Study ◽  
Test Method ◽  
Teaching Hospitals ◽  
Clinical Samples ◽  
Cross Sectional ◽  
Inducible Clindamycin Resistance ◽  
Resistance Patterns ◽  
Southwest Of Iran

Background: Macrolides, Lincosamides and type B Streptogramins (MLSB) are commonly used for the treatment of Staphylococcal infections. Inducible MLSB resistance (iMLSB) cannot be identified by standard methods of antibiotic susceptibility testing. D-test appears to be a reliable indicator of iMLSB strains. The aim of this study was to determine the prevalence of Clindamycin resistance phenotypes in Staphylococcus aureus (S.aureus) isolated from clinical samples in Shiraz, southwest of Iran.Materials and Methods: This cross-sectional study was performed on a total of 302 S. aureus isolates which were collected from two teaching hospitals in Shiraz during 2012. Methicillin resistant Staphylococcus aureus (MRSA) were screened based on their resistance to 30μg Cefoxitin disk. 168 Methicillin-sensitive Staphylococcus aureus (MSSA) and 134 MRSA isolates were tested in this study. The isolates were tested for susceptibility to Clindamycin (2 µg) and Erythromycin (15 µg) by Clinical and Laboratory Standards Institute (CLSI) recommended disk diffusion test.Results: Of 302 collected S. aureus isolates, 134 (44.4%) were MRSA and 168 (55.6%) were MSSA. Inducible MLSB resistance was observed in 10.4% of all recovered MRSA and 3% of all MSSA isolates. The majority of MRSA isolates (77.6%) constituted MLSB phenotype (cMLSB); this phenotype was seen in 4.1% of our tested MSSA isolates. Finally, 12.0% of MRSA isolates and 89.9% of MSSA showed sensitivity to both Erythromycin and Clindamycin.Conclusion: Different resistance patterns in hospitals indicated that performing routine D-test for S. aureus infections is highly recommended for each medical center. [GMJ. 2014;3(4):216-21]

The Prevalence of Colonization With Vancomycin-Resistant Enterococcus at a Veterans' Affairs Institution

1999 ◽  
Vol 20 (03) ◽  
pp. 171-175 ◽  
Author(s):  
Jerome I. Tokars ◽  
Sachiko Satake ◽  
David Rimland ◽  
Loretta Carson ◽  
Elaine R. Miller ◽  
...  
Keyword(s):  
Risk Factors ◽  
Rectal Swab ◽  
Medical Center ◽  
Antibiotic Use ◽  
Veterans Affairs ◽  
Antimicrobial Use ◽  
Vancomycin Resistant Enterococcus ◽  
Hospital Patients ◽  
Vancomycin Resistant ◽  
Hospital Inpatients

AbstractObjective:To study vancomycin-resistantEnterococcus(VRE) prevalence, risk factors, and clustering among hospital inpatients.Design:Rectal-swab prevalence culture survey conducted from February 5 to March 22,1996.Setting:The Veterans' Affairs Medical Center, Atlanta, Georgia.Patients:Hospital (medical and surgical) inpatients.Results:The overall VRE prevalence was 29% (42/147 patients). The VRE prevalence was 52% (38/73 patients) among patients who had received at least one of six specific antimicrobials during the preceding 120 days, compared with only 5% (4/74) among those who had not received the antimicrobials (relative risk, 9.6;P&lt;.001). The longer the period (up to 120 days) during which antimicrobial use was studied, the more closely VRE status was predicted. Among 67 hospital patients in 28 multibed rooms, clustering of VRE among current roommates was not found.Conclusions:At this hospital with relatively high VRE prevalence, VRE colonization was related to antibiotic use but not to roommate VRE status. In hospitals with a similar VRE epidemiology, obtaining cultures from roommates of VRE-positive patients may not be as efficient a strategy for identifying VRE-colonized patients as obtaining screening cultures from patients who have received antimicrobials.

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