Abstract
A nationwide epidemiologic study of clinical Staphylococcus isolates was performed in Italy by 24 operative units distributed throughout the country. A total of 7,017 Staphylococcus strains were examined according to a standard protocol. Three species of acknowledged importance in human infections (namely S. aureus, S. epidermidis, and S. saprophyticus) were identified singly, whereas the other staphylococci were considered as a whole and designated Staphylococcus spp. S. aureus totalled 53% of total isolates and was reported by most operative units as the predominant species among isolates both from various inpatient departments and from outpatients. S. saprophyticus was twofold more frequent among isolates from out- than from inpatients. Susceptibility to methicillin varied considerably from hospital to hospital, but a general tendency toward an increasing spread of resistance was noted. The overall incidence of methicillin resistance (29%) resulted from' a wide. range of values generally higher in isolates from inpatients (35°0) than from outpatients (21%). Particularly high percentages of resistance (45%) were recorded in isolates from intensive care departments. Susceptibility testing to four additional β-lactams (cefoxitin, cefuroxime, cefotaxime, and piperacillin) and to four aminoglycosides (gentamicin, tobramycin, amikacin, and netilmicin) indicated that antibiotic resistance was widespread and in all species more frequent among methicillin-resistant than among methicillin-sensitive staphylococci. Netilmicm proved more active than the other antibiotics tested; its greater activity was most evident against methicillin-resistant strains. Coagulase-negative staphylococci were more resistant than S. aureus to methicillin and most of the other antibiotics, suggesting their increasing involvement in human infections.
Similar content being viewed by others
References
Barber M. (1961): Methicillin-resistant staphylococci.- J. Clin. Pathol., 14: 385–393.
Barry A.L. and Tkornsberry C. (1980): Susceptibility testing: diffusion test procedures, p. 463–474. In E.H. Lennette, A. Balows, W.J. Hausler, Jr. and J.P. Truant (ed.), Manual of clinical microbiology, 3rd ed. American Society for Microbiology, Washington.
Boyce J.M. (1980): Methicillin-resistant Staphylococcus aureus infections: a growing infection control problem? - Infect. Control. 1: 335–336.
Haley R.W., Hightower A.W., Khabbnz R.F., ThornsberryC., Martone W.J., Allen J.R. and Hughes J.M. (1982): The emergence of methicillin resistant Staphylococcus aureus infections in United States Hospitals. Ann. Int. Med., 97: 297–308.
Hovelius B. and Mardh P.A. (1984): Staphylococcus saprophyticus as a common cause of urinary tract infections. - Rev. Infect. Dis., 6: 328–337.
Jessen O., Rosendal K., Bülow P., Faber V. and Eriksen K.R. (1969): Changing staphylococci and staphylococcal infections. A ten-year study of bacteria and cases of bacteremia. - N. Engl. J. Med., 281: 627–635.
Kayser F.H. (1975): Methicillin-resistant staphylococci 1965–75. - Lancet, ii: 650–653.
Keane C.T. and Cafferkey M.T. (1984): Re-emergence of methicillin-resistant Staphylococcus aureus causing severe infections. - J. Infect. 9: 6–16.
Kloos W.E. and Smith B. (1980): Staphylococci, p. 83–87. In E.H. Lennette, A, Balows, W.J. Hausler, Jr. and J.P. Truant (ed.), Manual of clinical microbiology, 3rd ed. American Society for Microbiology, Washington.
Lacey R.W. (1975): Antibiotic resistance plasmids of Staphylococcus aureus and their clinical importance.- Bacteriol. Rev., 39: 1–32.
McDonald P.J. (1982): Methicillin-resistant staphylococci. A sign of the times? - Med. J, Austr., i: 445–446.
Sabath L.D. (1977): Chemical and physical factors influencing methicillin resistance of Staphylococcus aureus and Staphylococcus epidermidis. - J. Antimicrob. Chemother., 3 (Suppl. C): 47–51.
Scragg J.N., Applebaurn P.C. and Govender D.A. (1978): The spectrum of infection and sensitivity of organisms isolated from African and Indian children in a Durban hospital. - Trans. R. Soc. Trop. Med. Hyg., 72: 325–328.
Thompson R.L., Cabezudo J. and Wenzel R.P. (1982): Epidemiology of nosocomial infections caused by methicillin-resistant Staphylococcus aureus.- Ann. Int. Med., 97: 309–317.
Varaldo P.E., Cipriani P., Focà A., Geraci C., GiordanoA., Madeddu M.A., Orsi A., Pompei R., PrennaM., Repetto A., Ripa S., Rosselli P., Russo G., Scazzocchio F. and Stassi G. (1984): Identification, clinical distribution, and susceptibility to methicillin and 18 additional antibiotics of clinical Staphylococcus isolates: nationwide investigation in Italy. - J. Clin. Microbiol., 19: 838–843.
Varaldo P.E., Grazi G., Soro O., Cisani G. and Satta G. (1980): Simplified lyogroup system, a new method for routine identification of staphylococci: description and comparison with three other methods. - J. Clin. Microbiol., 12: 63–68.
Varaldo P.E., Soro O., Grazi G. and Biavasco F. (1981): Clinical distribution and antibiotic sensitivities of staphylococcal strains isolated over an eight-month period. - J.Clin. Pathol., 34: 443–447.
Wenzel R.P. (1982): The emergence of methicillin-resistant Staphylococcus aureus. - Ann. Int. Med., 97: 440–442.
Author information
Authors and Affiliations
Consortia
Additional information
Corresponding author.
Rights and permissions
About this article
Cite this article
Varaldo, P.E., Italian Microbial Epidemiology Study Group. Epidemiologic study of Staphylococcus strains isolated from clinical material in 24 Italian Hospitals. Eur J Epidemiol 2, 208 (1986). https://doi.org/10.1007/BF00211534
Issue Date:
DOI: https://doi.org/10.1007/BF00211534