Drug-resistant coagulase-negative skin staphylococci: Evaluation of four marker systems and epidemiology in an orthopaedic ward

• Published in: Epidemiology and infection Vol. 105; no. 1; pp. 95 - 105
• Main Authors: Thore, M., Kühn, I., Löfdahl, S., Burman, L. G.
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.08.1990
• Subjects: Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents - pharmacology; Antibiotics; Bacterial Typing Techniques; Bacteriology; Biochemistry; Biological and medical sciences; Carrier State - epidemiology; Carrier State - microbiology; Cross Infection - epidemiology; Cross Infection - microbiology; DNA, Bacterial - analysis; Drug resistance; Drug Resistance, Microbial; Epidemiology; Female; Flora; Fundamental and applied biological sciences. Psychology; Hospital admissions; Hospital Units; Humans; Infections; Male; Microbial Sensitivity Tests; Microbiology; Middle Aged; Orthopedics; Plasmids; Special Article; Staphylococcal Infections - epidemiology; Staphylococcal Infections - microbiology; Staphylococcus; Staphylococcus - classification; Staphylococcus - drug effects; Staphylococcus - genetics; Staphylococcus epidermidis - classification; Staphylococcus epidermidis - drug effects; Staphylococcus epidermidis - genetics; Human; Skin disease; Typing; Hospital strain; Epidemiological marker; Epidemiology; Staphylococcus; Infection; Characterization; Resistance; Antibiotic; Bacteriosis; Bacteria; Micrococcales; Isolation; Micrococcaceae
• ISSN: 0950-2688; 1469-4409
• DOI: 10.1017/S0950268800047695

Drug-resistant coagulase-negative staphylococci (DRCNS) in orthopaedic patients and ward staff were studied. A significant increase in the DRCNS carriage rate was observed among the 16 patients studied after 14 days of hospitalization with levels approaching that of the staff. Patients receiving dicloxacillin prophylaxis (n=9) were more likely to be colonized with methicillin-resistant CNS, while patients receiving no antibiotics (n= 7) became to a larger extent colonized with multiple DRCNS. The combined data from species determination, biochemical, plasmid, and antibiogram typing revealed a considerable diversity among DRCNS;64 types were distinguished among 112 DRCNS isolates selected for study after exclusion of apparently duplicate isolates. Plasmid plus antibiogram typing yielded almost as many types (61); whereas species determination plus antibiogram distinguished only 33 types. Although a novel computerized 96-reaction boityping method alone enabled differentiation of 17 biotypes, most DRCNS isolates belonged to one of three major biotypes limiting the usefulness of this method. Ten of the 64 (16%) DRCNS types identified comprised 50 of the 112 (45%) isolates. These were isolated from staff and from patients on day 14, suggesting a nosocomial origin.