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Epidemiology and clinical features of methicillin-resistant Staphylococcus aureus in the University Hospital [Article de Revue]

 
[Epidémiologie et manifestations cliniques des infections à Staphylococcus aureus résistant à la méthicilline dans un hôpital universitaire de Djeddah, en Arabie saoudite]
Madani, Tariq Ahmed
The Canadian Journal of infectious diseases and medical microbiology. 2002/07; 13(4) : 245-250
Summary: La fréquence des cas de Staphylococcus aureus méthicillinorésistant (SAMR) augmente dans la plupart des hôpitaux et des autres établissements de soins du Canada. L'organisme peut provoquer des infections mettant en jeu le pronostic vital et s'associe à des flambées nosocomiales. Plusieurs études confirment que l'infection à SAMR s'associe à une augmentation de la morbidité et de la mortalité par rapport aux infections causées par des souches susceptibles, même en tenant compte de la présence de comorbidités. Le traitement de l'infection à

SAMR se complique par le fait que ces organismes résistent à de multiplesantimicrobiens, ce qui limite les possibilités de traitement. L'efficacité dutraitement par décolonisation (une tentative d'éradiquer le portage deSAMR) est également incertaine. Le présent article permet d'analyser laprise en charge médicale des infections à SAMR, traite du rôle potentielde la décolonisation et fournit un aperçu des données probantespermettant de soutenir les pratiques recommandées de contrôle del'infection.

OBJECTIVE: To describe the prevalence, demography and clinical characteristics of patients who were colonized or infected with methicillin-resistant Staphylococcus aureus (MRSA) in 1998 at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. PATIENTS AND METHODS: Results of MRSA-positive cultures of clinical specimens obtained as part of investigations for suspected infections were retrieved from the King Abdulaziz University Hospital Infection Control department's records. Charts of patients were reviewed.RESULTS: Of 292 S aureus isolates identified, 111 (38%) were MRSA, or 6.0 MRSA isolates/1000 admissions, which represented a marked increase over MRSA prevalence in 1988 (less than 2%). Nosocomial acquisition occurred in 74.8% of isolates. All age groups were affected, but 45.9% of patients were in the'extremes of age' group (younger than one or older than 60 years of age). The prevalence was highest in the medical ward (27%), followed by the paediatrics combined medical and surgical ward (20.7%), the outpatient department (18%), the adult surgical ward (17.1%) and the intensive care units (17.1%). Two-thirds(66.7%) of cases represented infection and the remainder represented colonization. Surgical wounds (31.1%), the chest (27%)
and endovascular catheters (20.3%) were the most common sites of infection. Bacteremia occurred in 27% of patients. Local signs (68.9%) and fever (60.8%) were the most common clinical manifestations. Respiratory distress and septic shock occurred in 28.4% and 6.8% of cases, respectively. Of 74 patients with MRSA infection and 37 patients with MRSA colonization, 91.9% and56.8% received antibiotics in the preceding six weeks, respectively (P<0.0001). The total mortality of patients with MRSA infection was 60.8%; 37.8% of deaths were the result of MRSA infection and 23% were the result of other diseases.CONCLUSIONS: The prevalence of MRSA is high and rapidly increasing at King Abdulaziz University Hospital, as it is worldwide. Control measures to prevent the spread of MRSA in hospitals should continue with reinforcement of hygienic precautions and development of policies to restrict the use of antibiotics.(RESUME D'AUTEUR)
Publication
2002/07

Pages
245-250

Language
Anglais

Number of ref
45

Published in
The Canadian Journal of infectious diseases and medical microbiology

ID notice
318872

Location Call number Status Date due Barcode
CCLIN Est
CClin Est
CHU de Nancy - Hôpitaux de Brabois
Rue du Morvan
54511 Vandoeuvre le Nancy Cedex
Tél : 03.83.15.34.73
cclin.est@chu-nancy.fr
http://www.cclin-est.org/
CCLIN Ouest
CClin Ouest
CHU Hôtel Dieu
CS 26419
35064 Rennes Cedex 2
Tél : 02.99.87.35.31
isabelle.girot@chu-rennes.fr
http://www.cclinouest.com/
CCLIN Paris Nord
CClin Paris-Nord
96 rue Didot
75014 Paris
Tél : 01.40.27.42.00  
karin.lebascle@sap.aphp.fr
http://www.cclinparisnord.org/
CCLIN Sud-Est
CClin Sud-Est
Hospices Civils de Lyon
Hôpital Henry Gabriel
20 route de vourles
69230 Saint-Genis-Laval
Tél : 04.78.86.49.50
cclinse@chu-lyon.fr
http://cclin-sudest.chu-lyon.fr/
CCLIN Sud-Ouest
CClin Sud-Ouest
CHU de Bordeaux
Hôpital Pellegrin - Bâtiment Le Tondu
33076 Bordeaux
Tél : 05.56.79.60.58
cclin.so@chu-bordeaux.fr
http://www.cclin-sudouest.com/

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