Association of borderline oxacillin-susceptible strains of Staphylococcus aureus with surgical wound infections

被引:24
作者
Kernodle, DS
Classen, DC
Stratton, CW
Kaiser, AB
机构
[1] Vanderbilt Univ, Med Ctr, Div Infect Dis, MCN A3310, Nashville, TN 37232 USA
[2] Vanderbilt Univ, Sch Med, Dept Med, Nashville, TN 37232 USA
[3] Vanderbilt Univ, Sch Med, Dept Pathol, Nashville, TN 37232 USA
[4] Dept Vet Affairs Med Ctr, Nashville, TN 37212 USA
[5] Latter Day St Hosp, Dept Med, Div Infect Dis, Salt Lake City, UT 84143 USA
关键词
D O I
10.1128/JCM.36.1.219-222.1998
中图分类号
Q93 [微生物学];
学科分类号
071005 ; 100705 ;
摘要
Staphylococcus aureus isolates which produce type A staphylococcal beta-lactamase have been associated with wound infections complicating the use of cefazolin prophylaxis in surgery. To further evaluate this finding, 215 wound isolates from 14 cities in the United States were characterized by antimicrobial susceptibility and beta-lactamase type and correlated with the preoperative prophylactic regimen. Borderline-susceptible S. aureas isolates of phage group 5 (BSSA-5), which produce large amounts of type A beta-lactamase and exhibit borderline susceptibility to oxacillin, comprised a greater percentage of the 120 wound isolates associated with cefazolin prophylaxis than they did of the 95 isolates associated with other prophylactic regimens (25% versus 12.6%, respectively; P < 0.05). In contrast, methicillin-resistant S, aureus isolates were distributed evenly between the two groups (8.3% versus 11.6%, respectively). In vitro assays demonstrated that cefazolin was hydrolyzed faster by BSSA-5 strains than by other beta-lactamase-producing, methicillin-susceptible strains (1.54 versus 0.50 mu g/min/10(8) CFU, respectively; P < 0.0001). These data demonstrate that BSSA-5 strains are a distinct subpopulation of methicillin-susceptible S, aureus which frequently cause deep surgical wound infections. Cefazolin use in prophylaxis is a risk factor for BSSA-5 infection.
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页码:219 / 222
页数:4
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