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lamb L.A.M.Buisman at cable.A2000.nl
Wed Jan 19 15:36:20 EST 2000

Sak wrote:

> Most MRSA from our patients is found by "accident" from normal
> susceptibility testing of S. aureus isolated from cultures. Some
> hospitals in my area routinely take rectal and nasal swabs when a
> patient is admitted to screen for MRSA and VRE to get colonized
> patients into isolation. It is these admission screens that we use the
> test for.

Here in the Netherlands patients from hospitals in other countries are "suspect". They are
isolated until cultures on MRSA are proven negative. Other admissions are not screened, it
isn't worthwile.So a quick test here would save the patients almost a day in isolation.
Which is a nice thought.

> I don't really have any idea of how big MRSA is here, but I suspect it
> has more to do with patients with real infections of MRSA being
> treated with vancomycin and picking up VRE from some health care
> worker bringing it from another colonized patient. Isolation gives the
> workers the protocols to minimize transmission of any bugs between
> patients. If VRE trending is any indication, I would estimate I've
> seen a ten-fold increase in isolation of VRE in the past five years.

It is very rare here. I think I've seen one Str. faecium once with a borderline (right
word??) MIC. We also test routinely for teicoplanin, and see the strangest patterns with
coag.neg. staphylococci.

> 10 isolates were tested at BD. 39 isolates from the CDC were also
> tested at BD. 559 isolates were tested at three independent labs. I
> don't know of any published studies of the method.



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