Surveillance van meticilline resistance Staphylococcus aureus in Nederland in 1989

Abstract

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A surveillance study on methicillin resistant Staphylococcus aureus (MRSA) in the Netherlands was started in January 1989 by the National Institute of Public Health & Environmental Protection (RIVM) in Bilthoven. Twenty-nine laboratories sent about 150 MRSA-isolates of patients and personnel in 1989. These isolates were phagetyped by the Laboratory for Bacteriology and M.I.C.-values for about 14 antibiotics were determined in the Laboratory for Chemotherapy. Thirty-two phagetypes were found of which twenty phagetypes were isolated only once. Of the more frequent phagetypes, expecially phagetypes "g" and "e", were by far most prevalent, being isolated fifty and fifty-five times respectively. Both phagetypes were associated with hospital epidemics in the Netherlands in and before 1989. Almost all MRSA- isolates were multiresistant strains. One third of the isolates was resistant to rifampicin, and only one fourth of MRSA-isolates was resistant to cotrimoxazole. All isolates were sensitive to fusidic acid and vancomycin. Introduction of a MRSA-strain into a Dutch hospital is often associated with transfer of patients, who have been nursed in a foreign hospital. They have been colonized with an "endemic" MRSA-strain in this hospital. Strict isolation procedures of these patients in Dutch hospitals are necessary till repeated routine cultures are negative for MRSA. In case of interhospital transfer of MRSA-poitive patients, good communication between the hospitals concerned is important. Multiresistant staphylococci are a serious problem in hospital epidemiology and treatment of associated infections.