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. 2004 Jul-Aug;5(4):256-8.
doi: 10.1097/01.JAM.0000129820.98979.45.

Antimicrobial use and methicillin-resistant Staphylococcus aureus in a large nursing home

Paul J Drinka  1 , Cathy Gauerke, Debbie Le
Affiliations

Antimicrobial use and methicillin-resistant Staphylococcus aureus in a large nursing home

Paul J Drinka et al. J Am Med Dir Assoc. 2004 Jul-Aug.

Abstract

Introduction: In 1997, 18% of Staphylococcus aureus clinical isolates at the Wisconsin Veterans Home were resistant to methicillin. By 2002, 51% were resistant.

Methods: We determined the antibiotic sensitivity pattern of our methicillin-resistant S. aureus (MRSA) isolates as well as changes in utilization of specific antibiotics between two time periods. We reasoned that antibiotics with activity against methicillin-sensitive S. aureus (MSSA), but not MRSA, might be driving the overgrowth of MRSA.

Results: In our facility, MRSA is usually resistant to quinolones; MSSA is usually sensitive. Both MSSA and MRSA are usually sensitive to TMP-sulfa. An increased percentage of S. aureus resistant to methicillin (18%) was associated with a 42% increase in quinolone use and a 37% decrease in TMP-sulfa use.

Conclusion: Our analysis and previous reports suggest that replacement of TMP-sulfa by quinolones could be selecting MRSA in our facility. This conclusion, however, is speculative, based on association, and requires confirmation.

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