Journal Article

Reemergence of Gentamicin-Susceptible Strains of Methicillin-Resistant <i>Staphylococcus aureus</i>: Roles of an Infection Control Program and Changes in Aminoglycoside Use

Hélène Aubry-Damon, Patrick Legrand, Christian Brun-Buisson, Alain Astier, Claude-James Soussy and Roland Leclercq

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 25, issue 3, pages 647-653
Published in print September 1997 | ISSN: 1058-4838
Published online September 1997 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/513749
Reemergence of Gentamicin-Susceptible Strains of Methicillin-Resistant Staphylococcus aureus: Roles of an Infection Control Program and Changes in Aminoglycoside Use

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The spread of methicillin-resistant Staphylococcus aureus (MRSA) in our hospital in the 1980s correlated with increasing acquisition of resistance to antibiotics including gentamicin, rifampin, and fluoroquinolones. During the period 1993–1995, there was a major change in clinical MRSA isolates: the percentage of aminoglycoside-resistant MRSA isolates decreased from 75% to 52%, while the proportion of heterogeneous MRSA strains susceptible to gentamicin, rifampin, and tetracycline increased gradually from 4.9% to 27.5%. We used five epidemiological markers (i.e., antibiotyping, phage typing, pulsed-field gel electrophoresis, and restriction analysis of PCR amplified coagulase and protein A genes) to characterize recent isolates. With use of these techniques, we confirmed the persistence of the aminoglycoside-resistant MRSA clone and identified a clone of erythromycinsusceptible strains among the gentamicin-susceptible isolates and found that the remaining strains were diverse. These changes were due to the introduction of various MRSA strains from outside the hospital, while implementation of infection control measures in 1991 could have led to reduced transmission of the aminoglycoside-resistant MRSA strain. Changes in antibiotic prescribing patterns that resulted in reduced selective pressure from gentamicin may have contributed to the spread of gentamicin-susceptible MRSA strains.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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