Skip to main content

Resistance to methicillin and virulence ofStaphylococcus aureus strains in bacteriemic cancer patients

Intensive Care Medicine volume 19, pages 285–289 (1993)Cite this article

Summary

Objective

To estimate the relation between resistance to methicillin and virulence in strains ofStaph. aureus by estimating the survival at day 30.

Design

Case control analysis.

Setting

Inpatients at a major Cancer Referral Center.

Patients

21 patients with methicillin-resistantStaph. aureus (MRSA) bactaeremia and 45 patients with methicillin-susceptibleStaph. aureus (MSSA) bactaeremia, all treated with vancomycin.

Measurements and main results

Fewer MRSA than MSSA patients were neutropenic (p=0.04), but more MRSA patients were hospitalized in intensive care units (p=0.03), had had surgical episodes (p=0.06). MRSA patients also had more microbiological samples cultured (p=0.007). The outcome of the bacteriemic episodes in 14 MRSA and 14 MSSA patients matched for these four factors showed that blood cultures from MRSA patients remained positive significantly longer (p=0.04), but that survival and length of hospital stay were not significantly different.

Conclusions

These results do not indicate that methicillin-resistance inStaph. aureus is associated with increased virulence.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

References

  1. Rot P, Mamet JP, Goulet V (1990) Relevé des bactéries isolées dans les hémocultures en 1987–88. Bull Epidémiol Hebdomadaire Paris: Ministère de la Santé 33:142–143

    Google Scholar 

  2. Horan TC, White JW, Jarvis WR, Emori TG, Culver DH, Munn VP, Thornsberry C, Olson DR, Hugues JM (1986) Nosocomial infection surveillance. MMWR 35:17SS-29SS

    CAS  PubMed  Google Scholar 

  3. Mac Govan JE Jr (1988) Gram positive bacteria spread and antimicrobial resistance in university and community hospitals in USA. J Antimicrob Chemother 21 [Suppl C]:49–55

    Article  Google Scholar 

  4. Acar JF, Buu-Hoi AY (1988) Resistance patterns of important Gram-positive pathogens. J Antimicrob Chemother 21 [Suppl C]:41–47

    CAS  Article  PubMed  Google Scholar 

  5. Chambers HF (1988) Methicillin-resistantStaphylococcus aureus. Clin Microbiol Rev 1:173–186

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  6. Watanakunakorn C (1982) Treatment of infections due to Methicillin-resistantStaphylococcus aureus. Ann Intern Med 97:376–378

    CAS  Article  PubMed  Google Scholar 

  7. Caillon J, Juvin ME, Pirault JL, Drugeon HB (1989) Activité bactéricide de la daptomycine (LY 146032) comparée à celle de la vancomycine et de la teicoplanine sur les bactéries à gram positif. Pathol Biol (Paris) 37:540–548

    CAS  Google Scholar 

  8. Holmberg SD, Solomon SL, Blake PA (1987) Health and economic impacts of antimicrobial resistance. Rev Infect Dis 9:1065–1078

    CAS  Article  PubMed  Google Scholar 

  9. Lacey RW, Kruczenyk SC (1986) Epidemiology of antibiotic resistance inStaphylococcus aureus. J Antimicrob Chemother 8 [Suppl C]:207–214

    Google Scholar 

  10. Crossley K, Loesch D, Landesman B, Mead K, Chern M, Strate R (1979) An outbreak of infections caused by strains ofStaphylococcus aureus resistant to methicillin and aminoglycosides. J Infect Dis 139:273–279

    CAS  Article  PubMed  Google Scholar 

  11. Locksley RM, Cohen ML, Quinn TC, Tompins LS, Coyle MB, Kirihara JM, Counts GW (1982) Multiple antibiotic resistantStaphylococcus aureus: introduction, transmission and evolution of nosocomial infection. Ann Intern Med 97:317–324

    CAS  Article  PubMed  Google Scholar 

  12. Mylotte JM, MacDermott C, Spooner JA (1987) Prospective study of 114 consecutive episodes ofStaphylococcus aureus bacteraemia. Rev Infect Dis 9:891–907

    CAS  Article  PubMed  Google Scholar 

  13. Peacock JE, Marsik FJ, Wenzel RP (1980) Methicillin-resistantStaphylococcus aureus: introduction and spread within a hospital. Ann Intern Med 93:526–532

    Article  PubMed  Google Scholar 

  14. Saravolatz LD, Markowitz N, Arking L, Pohlod D, Fisher E (1982) Methicillin-resistantStaphylococcus aureus: epidemiologic observations during a community acquired outbreak. Ann Intern Med 96:11–16

    CAS  Article  PubMed  Google Scholar 

  15. Sorrell TC, Packham DR, Shanker S, Foldes M, Munro R (1982) Vancomycin therapy for methicillin-resistantStaphylococcus aureus. Ann Intern Med 97:344–350

    CAS  Article  PubMed  Google Scholar 

  16. Marie JP, Pico J, Lapierre V, Maulard C, Pappo M, Chiche D, Andremont A, Lagrange Ph, Hayat M, Zittoun R (1991) Traitement empirique des épisodes fébriles survenant chez les patients cancéreux présentant une neutropénie prolongée: essai comparatif ceftazidime seule, ceftazidime+amikacine et ceftazidem+vancomycine. Med Mal Infect 21:386–388

    Article  Google Scholar 

  17. Chabbert YA, Boulingre H (1857) Modifications pratiques concernant le dosage des antibiotiques en clinique. Rev Fr Etudes Clin Biol (Paris) 2:636–640

    Google Scholar 

  18. Mac Dougal LK, Thornsberry C (1984) New recommendations for disk diffusion antimicrobial susceptibility tests for methicillin-resistant (heteroresistant) staphylococci. J Clin Microbiol 19:482–488

    Google Scholar 

  19. Steers E, Foltz EL, Graves BS (1959) An inocula replicating apparatus for routine testing of bacterial susceptibility to antibiotics. Antibiot Chemother 9:307–311

    CAS  Google Scholar 

  20. Drugeon HB, Caillon J, Juvin ME, Pirault JL (1987) Dynamics of ceftazidime-pefloxacin interaction shown by a new killing curvechequerboard method. J Antimicrob Chemother 19:197–203

    CAS  Article  PubMed  Google Scholar 

  21. Wartelle M, Kramar A, Jan P, Kruger D (1983) PIGAS: An interactive statistical database management system. In: Proceedings of the Second International Workshop on Statistical Database Management. Springfield, Va, National Technical Information Service, US Department of Commerce, pp 124–132

    Google Scholar 

  22. Schlesselman JJ (1982) Basic methods of analysis. In: Schlesselman JJ (ed) Case-control studies. Oxford University Press, New-York, pp 171–226

    Google Scholar 

Download references

Author information

Affiliations

  1. Service de Microbiologie Médicale, Institut Gustave-Roussy, F-94800, Villejuif, France

    L. Marty, B. Suarez & A. Andremont MD

  2. Département de Statistiques, Institut Gustave-Roussy, F-94800, Villejuif, France

    A. Flahault & C. Hill

  3. Laboratoire de Bactériologie B, Hôpital Laënnec, Nantes, France

    J. Caillon

  4. Laboratoire de Microbiologie, Faculté de Pharmacie, Chatenay-Malabry, France

    A. Andremont MD

Authors
  1. L. Marty
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Flahault
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. B. Suarez
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. Caillon
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. C. Hill
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. A. Andremont MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Marty, L., Flahault, A., Suarez, B. et al. Resistance to methicillin and virulence ofStaphylococcus aureus strains in bacteriemic cancer patients. Intensive Care Med 19, 285–289 (1993). https://doi.org/10.1007/BF01690549

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01690549

Key words

  • Epidemiology
  • Mortality
  • Staphylococcus aureus