bjectives : Infections cased by methicillin-resistant Staphylococcus aureus (MRSA) strains are serious medical problems because only a few effctive therapeutic agents are available. Some fluoroquinolones, such as ofloxacin, ciprolfloxacin and
others,
have been used for the treatment of MRSA infections. However, along with their wide use, the emergence of fluoroquinolone-resistant strains of Staphylococcus aureus has been recently reported.
Methods : Authors studied the development of ciprofloxacin resistance in MRSA and
prevalence of MRSA among staphylcocci isolates retrospectively in Guro hospital from June
1990 to June 1992. Total 929 isolates of S.aureus were tested for the resistance to
ciprofloxacin by Kirby-Bauer disc diffusion method.
Results : Among 929 isolates, 425 (45.7%) isolates were MRSA and 504 (54.3%) isolates
were MSSA (methicillin-susceptible S.aureus). Among 660 isolates from in patients. MRSA
were 336 (50.9%) isolates and MSSA were 324 (49.1%) isolates. Among 269 isolates from
out-patients, MRSA were 89 (33.1%) isolates and MSSA were 180 (66.9%) isolates. 192
(45.2%) isolates of MRSA and 9 (1.6%) isolates of MSSA were tested for the resistance to
ciprofloxacin by disc diffusion method. Prevalence of ciprofloxacin-resistant MRSA by month
is 0% for the first 4 months, 6.7% on October 1990, 18.5% on November 1990, 53.3% on
December 1990, 66.7% on June 1991, and 70% on June 1992. Among 171 patients with
ciprofloxacin-resistant S. aureus isolates, 148 (86.5%) patients had nosocomial acquisition. And
only 31 (18%) patients had a history of previous ciprofloxacin use. Ciprofloxacin-resistant
MRSA isolates were most commonly recovered from sputum, wound, ear and eye discharge,
urine, and closed pus specimens in order of incidence.
Conclusion : Ciprofloxacin resistance of MRSA which was isolated from tertiary hosptial
was also rapidly developed in Korea. More judicious use of new antibiotics and further study
for the mechanism of ciprofloxacin resistance are required.
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