Methicillin-resistant Staphylococcus aureus in two tertiary-care centers in Jeddah, Saudi Arabia

OBJECTIVE: To review clinical experience with methicillin-resistant Staphyl ococcus aureus (MRSA) in tertiary-care hospitals in Jeddah, Saudi Arabia. DESIGN: Retrospective review for the year 1998. SETTING: Two tertiary-care hospitals. METHODS: Results of MRSA-positive cultures of clinical specimens obtained a s part of investigations for suspected infections were retrieved from the m icrobiology laboratories' records. Charts of patients were reviewed, with s tandardized data collection. RESULTS: Of 673 S aureus isolates identified, 222 (33%, or 6.8 isolates/1,0 00 admissions) were MRSA. Overall MRSA prevalence was 2% in 1988. Nosocomia l acquisition occurred in 84.2% of cases. All age groups were affected, and 52% of patients had at least one comorbidity. MRSA prevalence was highest in the intensive care units (26.6% of ah isolates), the medical wards (24.8 %), and the surgical wards (19.896). Seventy-three percent of isolates caus ed infection; the rest represented colonization. Surgical wounds (35.2%), t he chest (29%), and central venous catheters (13%) were the most common sit es of infection. Bacteremia occurred in 15.4% of patients. Local signs (84% ) and fever (75.9%) were the most common clinical manifestations. Respirato ry distress and septic shock occurred in 30.2% and 13.6% of cases, respecti vely. Of 162 patients with MRSA infection and 60 patients with MRSA coloniz ation, 95.7% and 70% received antibiotics in the preceding 6 weeks, respect ively (P < .0001). The total mortality of patients with MRSA infection was 53.7%: 36.4% as a result of MRSA infection and 17.3% as a result of other c auses. CONCLUSIONS: The prevalence of MRSA is high and rapidly increasing in the t wo hospitals, as it is worldwide. Control measures to prevent the spread of MRSA in hospitals should continue, with reinforcement of hygienic precauti ons and development of policies to restrict the use of antibiotics.