Methicillin resistant Staphylococcus aureus

The prevalence of methicillin resistant Staphylococcus aureus (MRSA) at the Gene, al Hospital, port-of Spain, between June 1995 and May 1996 was deter mined. The MRSA prevalence rate was 4.6% of all S aureus isolates, with all but one nosocomially acquired. 15 isolates were associated with infections , and three were colonizing strains. 17 of the 18 patients with MRSA herd r eceived antibiotics previously, including 13 who had received multiple anti biotics. Skin and soft tissue were the sites of infection and colonization in 12 cases; and surgical wards and the Intensive Care Unit (ICU) accounted for 16 MRSA isolates. All isolates were sensitive to vancomycin and all bu t one were,resistant to gentamicin. MRSA occurred sporadically in a wide di stribution of wards and physicians' services, although the isolation of thr ee strains from the ICU and three strains from a surgical ward were tempora lly related. Only one of two deaths was attributable to MRSA. Control of th e spread of MRSA in this hospital must include the reinforcement of the app ropriate use of antibiotics, hand washing and appropriate isolation of pati ents in the surgical and intensive care wards.