Staphylococcus aureus, one of the most frequently isolated pathogens in both hospitals and the community, has been particularly efficient at developing resistance to antimicrobial agents. As methicillin-resistant S. aureus (MRSA) has prevailed and, furthermore, as S. aureus with reduced susceptibility to vancomycin has emerged, the therapeutic options for the treatment of S. aureus infections have become limited. To update the current status of antibiotic resistance, clinical S. aureus isolates were collected from eight university-affiliated hospitals from June 1999 to January 2001. Susceptibility tests with 28 antibiotics were performed by the disk diffusion method. Among a total of 682 isolates, the methicillin resistance rate was 64% (439 of 682), and most of the MRSA isolates were resistant to multiple classes of antibiotics. Although a constitutive macrolidelincosamide-streptogramin B resistance phenotype was common, no isolates were resistant to quinupristindalfopristin or linezolid. Rifampin, fusidic acid, trimethoprim-sulfamethoxazole, and arbekacin showed superior in vitro activity compared with the other antibiotics against the MRSA isolates. No isolates showed reduced susceptibility to vancomycin.Staphylococcus aureus is an important cause of serious infections in both hospitals and the community (16). S. aureus has been found to be the most frequently isolated pathogen causing bloodstream infections, skin and soft tissue infections, and pneumonia (6,19,20). Unfortunately this pathogen has been particularly efficient at developing resistance to antimicrobial agents. Since the first isolation of methicillin-resistant S. aureus (MRSA) in the United Kingdom in 1961 (12), increasing rates of methicillin resistance among S. aureus strains have been a cause for concern. In addition, MRSA has become resistant to multiple other antimicrobial agents. Until recently, vancomycin was believed to have retained activity against all strains of S. aureus; therefore, the spread of MRSA has led to increased vancomycin usage and hence increased selective pressure for the development of resistance.In 1997, the first documented infection caused by S. aureus with reduced susceptibility to vancomycin (vancomycin-intermediate S. aureus) was reported in Japan (9). Subsequently, similar strains with reduced susceptibility to vancomycin were identified in several countries, including Korea (25). The aims of the present study were to analyze nationwide data on the susceptibilities of S. aureus isolates from tertiarycare hospitals and to improve the empirical approaches to the therapy of serious infections.(This work was presented in part at the 41st Annual Interscience Conference on Antimicrobial Agents and Chemotherapy, Chicago, Ill., 16 to 19 December 2001.)
MATERIALS AND METHODSBacterial isolates. Clinical S. aureus isolates were collected from eight university-affiliated hospitals, each hospital representing one of eight provinces in Korea. From June 1999 to January 2001, each participating hospital sent 100 consecutive isol...