J.Jpn. Surg. Soc.. 90(4): 517-523, 1989

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Original article

EXPERIENCES OF POSTOPERATIVE STAPHYLOCOCCAL ENTERITIS CAUSED BY METHICILLIN-CEPHEM RESISTANT STAPHY-LOCOCCUS AUREUS (MRSA) AND THE STATE OF THE ISOLATION OF MRSA

During the last 12 months, three cases of postoperative Staphylococcal enteritis were experienced in our surgical ward. Kanamycin, Clindamycin and Latamoxef were given prophylactically in all cases.They developed dehydration with severe diarrhea and paralytic ileus on three to ten days after abdominal surgery. MRSA was cultured from the intestinal fluid or feces and Minocycline, sensitive anti-microbial agent to the organism, was administered intravenously and their conditions improved dramatically.
Since the nosocomial infections of MRSA are believed to be the cause of these cases, following items were investigated ; 1) the frequency of MRSA among Staphylococcus aureus clinically isolated from patients in surgical ward, 2) the state of nasal carriage of MRSA in medical staffs and inpatients without infections in surgical ward, 3) drug sensitivity of MRSA to ten kinds of antibiotics. The results were as follows ; 1) the frequency of MRSA was 83% of all the strains of Staphyloccus aureus, 2) the nasal carrier status was 2 in 46 medical staffs and 4 in 17 inpatients, 3) 124 strains of MRSA, 114 isolated from patients and 10 from nasal carriers, showed the identical drug sensitivity, that is, MRSA is sensitive to Minocy- cline and resistant to every other antibiotics.
It is believed that these three cases were due to nosocomial infections of MRSA, and early diagnosis of MRSA enteritis should lead to early antibiotic therapy and to a cure of this serious postoperative complication.

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