Abstract
To investigate the characteristics, risk factors, and prevention of methicillin-resistant Staphylococcus aureus (MRSA), a total of 3,627 patients were studied. Among these, 1,336 patients with various infections were used in a risk factor analysis of MRSA to determine the relationship between the use of antibiotics and the incidence of MRSA. Only 3.0% of infections were attributed to MRSA, the esophagus and colorectal region being highly involved, as anastomotic or pelvic abscesses, while the lung had a lower incidence. Almost half the patients with MRSA infections (47.6%) had concomitant infections. A univariate analysis revealed the following significant factors: The coexistence of gastrointestinal or metastatic malignancy, sepsis, tracheostomy, and the prior use of antibiotics such as the β-lactam compounds or aminoglycosides. A multivariate analysis showed that gastrointestinal malignancy, sepsis, and the prior use of aminoglycosides, tetracycline, macrolides, and carbapenems were independently significant factors. To promote the education of doctors and nurses, regular in-service meetings on MRSA were held in the ward. Moreover, preventive approaches such as patient isolation, strategically placed hand washing equipment, and the use of disposable gloves and contaminated waste bags, have been initiated, and the incidence of MRSA has decreased significantly since then. Thus, to control MRSA, the following steps should be taken: (1) constant and careful surveillance, (2) regular risk factor analyses, (3) the optimal administration of antibiotics, and (4) the education of all hospital staff.
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References
Jevons MP (1961) “Celbenin”-resistant Staphylococci. Br Med J 1:124–125
Knox R (1961) “Celbenin”-resistant Staphylococci. Br Med J 1:126
Sheagren JN (1984) Staphylococcus aureus: The persistent pathogen. N Engl J Med 310:1368–1373, 1437–1442
Townsend DE, Ashdown N, Bolton S, Bradley J, Duckworth G, Moorhouse EC, Grubb WB (1987) The international spread of methicillin-resistant Staphylococcus aureus. J Hosp Infect 9:60–71
Brumfitt W, Hamilton-Miller J (1989) Methicillin-resistant Staphylococcus aureus. N Engl J Med 320:1188–1196
SAS User's Guide: Statistics, 5th edn., (1985) SAS Institution, Cary, North Carolina
SUGI Supplemental Library User's Guide 5th edn., (1986) SAS Institution, Cary, North Carolina
Forbes BA, McClatchey KD, Schaberg DR (1984) Subinhibitory concentrations of imipenem induce increased resistance to methicillin and imipenem in vitro in methicillin-resistant Staphylococcus aureus. Antimicrob Agents Chemother 25:491–493
Shigeno Y, Yamashiro T, Kusano N (1990) MRSA infection: Significance of MRSA in respiratory tract infection (in Japanese with English abstract). Rinshobyori (Jpn J Clin Pathol) 38:1005–1015
Takahashi M, Narisawa T, Kotanagi H, Yamasaki Y, Kusaka H, Koyama K, Nakagomi O (1990) Analysis of methicillin-cephem-resistant Staphylococcus aureus (MRSA) hospital infection and toxigenicity of MRSA (In Japanese with English abstract). Nippon Geka Gakkai Zasshi (J Jpn Surg Soc) 91:1554–1559
Allen DM (1991) Methicillin-resistant Staphylococcus aureus: Where are we now? Singapore Med J 32:17–19
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Shimada, M., Kamakura, T., Itasaka, H. et al. The significance of methicillin-resistant Staphylococcus Aureus infection in general surgery: A multivariate analysis of risk factors and preventive approaches. Surg Today 23, 880–884 (1993). https://doi.org/10.1007/BF00311366
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DOI: https://doi.org/10.1007/BF00311366