Epidemiological Investigation of ^|^beta;-lactam Antibiotic Induced Vancomycin-resistant MRSA from Clinical Isolated MRSA

Abstract

Recently, beta-lactam antibiotic induced vancomycin-resistant MRSA (BIVR) has been reported increasingly in Japan. Between 1998 and 2002, we tried to detect BIVR from 500 strains of MRSA in a cancer hospital. And the difference of the detection rate under condition of pre-culture with or without ceftizoxime was compared. The detection rate of BIVR under condition of pre-culture with 1.0 mg/L of ceftizoxime was 20.4% (102/500), and without ceftizoxime was 9% (45/500). That of preculture with 1.0 mg/L of ceftizoxime was higher than those without ceftizoxime with the significant difference. (p < 0.001; McNemar-t examination). In comparing each department, the detection rate of BIVR from Chemotherapy, Head & Neck, and Urology department was 33.3%, 27.0%, and 20.0%, respectively. These results mean that addition of beta-lactam as ceftizoxime in pre-culture induces the ability of resistance to vancomycin for MRSA having a capacity as BIVR.

Nosocomial infection of β-lactam antibiotic-induced vancomycin-resistant Staphylococcus aureus (BIVR)

“…4 However, another problem arose, with a new type of vancomycin-resistant MRSA, which emerged with the simultaneous use of vancomycin and β-lactam antibiotics; this organism exhibited elevated vancomycin resistance and has been designated as β-lactam-induced vancomycin-resistant MRSA (BIVR). [5][6][7][8][9] A model study showed that 100% of BIVR-infected mice treated with vancomycin alone survived, while only 20% of the infected mice treated with vancomycin and ceftizoxime survived. 10 Two cases of BIVR emergence were reported clinically, in a burn patient and a renal failure patient; both were initially treated with a combination of vancomycin and imipenem.…”

Methicillin-Resistant Staphylococcus aureus and New Delhi Metallo beta-lactamases- types of antibiotic resistance, methods of prevention.

“…The infection rates were in 6 patients (2.8%), 7 patients (3.5%) and 3 patients (1.4%) respectively, and it was observed Clinical success in 86 (68.3%) of the 126 patients included in the efficacy population. The monotherapy and combination subgroups had similar proportions of patients with success (69.7%, 64.9%, respectively), where the treatment period was 2 days (quadruple range of 1.5 to 4 days) for monotherapy, in 3 days (Quadruple range from 1.5 to 5 days) for combination therapy, where the results showed that cefazolin is effective for monotherapy or combination therapy (25,26,31).…”

“…S.aureus has been observed mainly in neonatal sepsis, skin and soft tissue infections, pneumonia, arthritis, osteoarthritis, endocarditis and postoperative sepsis. Multidose bacteria were encountered in all hospitals studied, penicillin resistance rates ranged from 40% to approximately 100%, while methicillin resistance rates of up to 52% have been reported in several hospitals (26,33).…”

“…The incidence was slightly higher than that of Pseudomonas aeroginose, the proportion of patients at one time or during burn stay increased from 1 to 112 days from 48% in 1995 to 52.7% in 1996, and no advanced tests were performed to determine the MRSA strain. However, the study of antibiotics showed that each of the positive isolates showed a very similar sensitivity to MRSA towards different antibiotics, as Vancomycin was the antibiotic that showed sensitivity to MRSA (26).…”