A study on pseudomembranous colitis and mrsa enterocoliitis in surgical inpatients who were treated with oral administration of vancomycin

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 69; no. 7; pp. 1565 - 1572
• Main Authors: TAMURA, Jun, KITAGUTI, Kazuhiko, SAKIKUBO, Morito, KAMIMURA, Ryo, OOE, Hideaki, YOSHIKAWA, Akira, ISHIGAMI, Shun-ichi, BABA, Nobuo, OGAWA, Hiroki, SAKANASHI, Shiro
• Format: Journal Article
• Language: Japanese
• Published: Japan Surgical Association 2008
• ISSN: 1345-2843; 1882-5133
• DOI: 10.3919/jjsa.69.1565

The incidence of Clostridium enteritis and MRSA enteritis in surgical inpatients who were treated with oral administration of vancomycin were analyzed. In 4867 patients admitted in the surgical ward in our hospital between January 2001 and April 2005, 41 patients received oral administration of vancomycin due to suspected pseudomembranous colitis or MRSA enteritis. These infection occurred postoperatively in the majority of the patients. In these 41 patients, 10 cases were diagnosed as pseudomembranous colitis by CD toxin test, and 10 cases diagnosed as MRSA enteritis by stool cultures. As a result, only 49% of patients were diagnosed correctly. On the other hand, 51% of the patients received unnecessary medication of vancomycin. In terms of antibiotics used to these patients before the attacks, carbapenems had about two fold higher risk of incidence of these enteritis than cepharosporins. MRSA enteritis mainly occurred after upper GI tract surgery, whereas no inclination was seen in clostridium enteritis in terms of site of operation. Guideline for oral administration of vancomycin is necessary for prevention of infection caused from vancomycin resistant organelle, such as VRE.