Clinical studies of enteritis caused by methicillin-resistant Staphylococcus aureus

Objective: To study the clinical features of methiciliin-resistant Staphylo coccus aureus (MRSA) enteritis in our surgical ward. Design: Retrospective study. Setting: Teaching hospital, Japan. Subjects: 16 men and 1 woman who developed MRSA enteritis from January 1995 to October 1999. Main outcome measures: Causes and treatments. Results: The underlying diseases were as follows: gastric cancer (n = 13), colorectal cancer (n = 2), recurrent cancer (n = 1) and bowel obstruction f ollowing gastrectomy (n = 1), 16 patients were operated on. Two cases were treated with histamine H2 receptor blockers. The mean age of patients was 6 5 years (range 50-80). In 13 cases MRSA enteritis developed within 6 days o f operation. 10 strains of MRSA were isolated from stools, 8 from gastric j uice, and 3 from intra-abdominal exudate, 10 patients were treated with van comycin given through a nasogastric tube and 2 through a nasogastric tube a nd by drip intravenous infusion, 15 patients survived and 2 died. Conclusions: Patients who are given broad-spectrum antibiotics and whose ga stric secretion is reduced are at high risk of MRSA enteritis. In the surgi cal ward, early diagnosis, treatment, and isolation are essential for patie nts with MRSA enteritis.