ANALYSIS OF ANTIBIOTIC SUSCEPTIBILITIES OF SKIN WOUND FLORA IN HOSPITALIZED DERMATOLOGY PATIENTS - THE CRISIS OF ANTIBIOTIC-RESISTANCE HAS COME TO THE SURFACE

Background: Results of an ongoing surveillance of antibiotic resistanc e in hospitalized dermatology patients are presented. Bacterial isolat es cultured from patients with skin wounds admitted to a tertiary care dermatology inpatient unit from May 1995 through May 1996 were evalua ted for resistance to commonly used antibiotics. Comparison was made w ith a previous survey of the same inpatient service from 1992. Our res ults show an alarming trend toward antibiotic resistance. Observation: In superficial skin wounds, Staphylococcus aureus constituted 77% of isolates. In leg ulcers, the frequencies of S aureus and Pseudomonas a eruginosa were approximately equal, constituting 43% and 42% of cultur es, respectively. Fifty percent of S aureus isolates from leg ulcers w ere resistant to oxacillin, with 36% of pseudomonad isolates resistant to ciprofloxacin. In superficial wounds, oxacillin resistance in S au reus approached 25%. A comparison of antibiotic resistance profiles us ing data collected in 1992 for patients admitted to the same inpatient service revealed a marked increase in oxacillin and ciprofloxacin res istance in S aureus and P aeruginosa in leg ulcers, respectively (from 24% to 50% oxacillin resistance in S aureus and from 9% to 24% ciprof loxacin resistance in P aeruginosa), and superficial wounds (24% to 36 % ciprofloxacin resistance in P aeruginosa). Conclusions: This study d emonstrates the rapid emergence of antibiotic-resistant bacteria as a problem of growing significance in hospital dermatology and highlights the importance of local surveillance programs to aid in selecting ant ibiotic treatments.