EMERGENCE OF CIPROFLOXACIN-RESISTANT COAGULASE-NEGATIVE STAPHYLOCOCCAL SKIN FLORA IN IMMUNOCOMPROMISED PATIENTS RECEIVING CIPROFLOXACIN

Seven septicemias in neutropenic leukemia patients (two with fatal outcome) caused by ciprofloxacin-resistant coagulase-negative staphylococci were diagnosed in the hematologic unit of Turku University Central Hospital in 1988soon after the introduction of the drug. Coagulasenegative staphylococcal skin flora of 28 neutropenic patients receiving ciprofloxacin prophylaxis and therapy for gram-negative bacterial infections were compared with those of 31 untreated patients and 33 hospital personnel working in the same unit. In ciprofloxacin-treated patients the flora were almost completely ciprofloxacin-resistant, whereas in the control groups resistant flora were detected only occasionally. Similarities in the plasmid profile patterns were found in 91%of the ciprofloxacin-resistant coagulase-negative staphylococci, suggesting an epidemiologic relation between these strains. It seems evident that cross-infection is responsible for the spread of ciprofloxacin-resistant coagulase-negative staphylococci in these patients. © 1990 by The University of Chicago. All rights reserved.