AI Article Synopsis
- The study focused on the increasing cases of pristinamycin-resistant Staphylococcus aureus (PRSA) in a dermatology department, which rose from 1% in 1998 to over 11% between 1999-2002.
- Researchers analyzed factors contributing to PRSA acquisition through a retrospective study comprising 23 cases and 46 controls, factoring in pristinamycin usage and antibiotic history.
- Findings indicated that higher pristinamycin use, cumulative antibiotic use exceeding a week, and methicillin resistance were significantly associated with PRSA, pointing to the influence of antimicrobial pressure and cross-transmission of bacteria.
Article Abstract
Background: Pristinamycin is used for the treatment of Staphylococcus aureus skin infection. Staphylococcus aureus pristinamycin resistance is usually low. The frequency of pristinamycin-resistant S. aureus (PRSA) increased in the Caen University Hospital dermatology department from 1% in 1998 to >11% in 1999-2002.
Objectives: This study aimed to identify the factors associated with PRSA acquisition.
Methods: Incidences of PRSA and pristinamycin consumption were calculated for the dermatology department and for the rest of the hospital from 1997 to 2007. Individual factors of PRSA acquisition in the dermatology department from 2000 to 2001 were analysed in a retrospective case-control study including 23 cases of PRSA skin colonization or infection and 46 controls with pristinamycin-susceptible S. aureus. Clonal relatedness of isolates was analysed by pulsed-field gel electrophoresis and pristinamycin resistance genes were detected by polymerase chain reaction. Conditional logistic regression was performed to analyse the relationship between pristinamycin resistance and epidemiological and microbiological data.
Results: PRSA frequency and pristinamycin consumption were significantly higher in the dermatology department than in other hospital departments. Two epidemic clones of two and six isolates were found for periods of 1 and 2 months, respectively. Thirteen of the 23 PRSA isolates (57%), including all isolates of the two epidemic clones, were found 48 h after the hospitalization or later. PRSA was associated with pristinamycin use during the previous year [odds ratio (OR) 5.60, 95% confidence interval (CI) 1.41-22.22], cumulative use of antibiotics exceeding 1 week during the previous year (OR 4.63, 95% CI 1.47-14.54) and methicillin resistance (OR 6.35, 95% CI 1.38-29.15).
Conclusions: Results suggest that antimicrobial selective pressure and microbial cross-transmission are involved in PRSA acquisition.
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| http://dx.doi.org/10.1111/j.1365-2133.2010.09826.x | DOI Listing |
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