Journal of Antimicrobial Chemotherapy (1999) 43, 160
© 1999 The British Society for Antimicrobial Chemotherapy
Correspondence |
Increasing prevalence of methicillin resistance amongst Staphylococcus aureus blood culture isolates
J Antimicrob Chemother 1999; 43: 160
Antibiotic Reference Unit, Central Public Health Laboratory, Colindale, London NW9 5HT, UK
Sir,
Staphylococcus aureus is the second commonest bacterial species isolated from bacteraemic patients. 1 Based on reports of the results of susceptibility testing of blood culture isolates forwarded to the Public Health Laboratory Service, we observed that the prevalence of methicillin resistance amongst S. aureus isolates increased from c. 1.5% in 1989- 91 to 21.1% in 1996. 2,3 On reviewing the data from 1997, we noted a further 50% increase compared with the previous year, with 31.7% of 7311 strains having been reported as resistant. This relentless increase in the number of methicillin-resistant S. aureus isolates will inevitably be associated with a corresponding increase in the use of glycopeptides as treatment of patients with infections caused by these organisms. This, in turn, will lead to increases in the selective pressure for glycopeptide- resistant enterococci, which are already being isolated in many hospitals, and for S. aureus isolates exhibiting intermediate resistance to vancomycin which, to date, have been detected in Japan, America and France. 4,5 ,6
Acknowledgments
These data were included in the recent report by the standing Medical Advisory Committee. 7
Notes
* Corresponding author. Tel: +44-181-200-4400; Fax:
+44-181-200-7449; E-mail: ajohnson{at}phls.co.uk 
References
1 . Anonymous. (1997). Bacteraemia and bacterial meningitis in England and Wales: 1982 to 1996. Communicable Disease Report 7, 275–8.
2 . Speller, D. C. E., Johnson, A. P., James, D., Marples, R. R., Charlett, A. & George, R. C. (1997). Resistance to methicillin and other antibiotics in isolates of Staphylococcus aureus from blood and cerebrospinal fluid, England and Wales, 1989- 95. Lancet 350, 323–5.[Web of Science][Medline]
3 . Johnson, A. P. & James, D. (1997). Continuing increase in invasive methicillin-resistant infection. Lancet 350, 1710.
4
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Hiramatsu, K., Hanaki, H., Ino, T., Yabuta, K., Oguri, T. & Tenover, F. C. (1997).
Methicillin-resistant Staphylococcus aureus clinical strain with reduced vancomycin
susceptibility. Journal of Antimicrobial Chemotherapy 40, 135–6.
5 . Center for Disease Control and Prevention. (1997). Staphylococcus aureus with reduced susceptibility to vancomycin—United States, 1997. Morbidity and Mortality Weekly Report 46,765 –6.
6 . Ploy, M. C., Grélaud, C., Martin, C., de Lumley, L. & Denis, F. (1998). First clinical isolate of vancomycin-intermediate Staphylococcus aureus in a French hospital. Lancet 351, 1212.[Web of Science][Medline]
7 . Standing Medical Advisory Committee Sub-Group on Antimicrobial Resistance (1998). The Path of Least Resistance. Department of Health, London.
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