Abstract
Clinical and bacteriological studies were performed on 45 cases of methicillin-resistant staphylococcus aureus (MRSA) infectious disease occurring after digestive system surgery encountered in the past nine months. To specifically identify the course and time of infection, sanitary conditions of the hospital and staffs were bacteriologically examined, as were patients' preoperative and postoperative throat cultures. Postoperative MRSA enterocolitis frequently occurred early on. Early diagnosis is crucial, and oral administration of vancomycin (VCM) and opium tincture were effective. MRSA was also detected in the hospital, in the throat cultures, and on the fingers of hospital staffs MRSA from most of the staffs were coagulase type II, as were from the patients. However, the minimum inhibitory concentration (MIC) of MRSA determined in staffs throat cultures differed from that in patient throat cultures. Although MRSA enterocolitis occurred in 15 of 51 surgical cases, no MRSA was detected from them pre- or intra-operatively. Postoperative insertion of a feeding tube did not increase the incidence of enterocolitis. It is thus likely that the MRSA infectious disease encountered at this hospital was a nosocomial infection, epidemic strain type II, and was postoperatively transmitted primarily from the fingers of the medical staffs. Thorough countermeasures to cope with nosocomial infection are likely necessary to prevent postoperative MRSA enteritis.
