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Carriage of Methicillin-resistant Coagulase-negative Staphylococci in Two Orthopaedic Wards Differing in Antibiotic Usage

OBJECTIVE: To study the colonization rates of methicillin-resistant coagulase-negative staphylococci (MRCoNS) among patients and nursing personnel in two orthopaedic wards differing in antibiotic usage. DESIGN: A non-randomized comparative study. SETTING: Two orthopaedic wards at a tertiary hospital, one ward comprising orthopaedic infections (E3) with a relatively high usage of antibiotics, and one orthopaedic ward (E6) without infected patients and a relatively lower usage of antibiotics. RESULTS: MRCoNS were acquired during admissions by 13% (11/87) and 15% (14/91) of the patients in E3 and E6, P = 0.76. The colonization rates of the nursing personnel were the same at the two wards, the highest rate at a given time was 61% (22/36). Among patients that had been hospitalized during the year prior to admission, the colonization rate of MRCoNS at the time of admission was 78% (21/27) for the fraction that had received antibiotic therapy during the month prior to admission and 20% (13/64) for those that had received none, P < 0.00005. MRCoNS were not recovered from patients who had received antibiotic therapy prior to admission but had not been hospitalized during the year prior to admission. CONCLUSIONS: A hospital ward, where antibiotics are relatively widely used, does not necessarily have a high colonization rate of the normal flora with MRCoNS. The combination of previous hospitalization and antibiotic therapy prior to admission is associated with a significantly higher rate of colonization with MRCoNS at the time of admission than antibiotic therapy or hospitalization as a risk factor alone.