Oral Vancomycin in the Control of MRSA Outbreaks in the ICU

  • M. A. de la Cal
  • E. Cerdá
  • M. Calderón
  • P. García-Hierro
  • H. K. F. van Saene
Part of the Topics in Anaesthesia and Critical Care book series (TIACC)


Methicillin-resistant Staphylococcus aureus (MRSA) is a serious problem, both clinically and epidemiologically. Systemic vancomycin is the cornerstone for the therapy of invasive infections due to MRSA. However, vancomycin is potentially toxic and there is an increasing fear that microorganisms resistant to vancomycin such as vancomycin-resistant enterococci (VRE) [1] and vancomycin intermediate Staphylococcus aureus (VISA) will emerge [2].


Selective Digestive Decontamination Oral Vancomycin Surveillance Sample Infection Control Practice Advisory Committee Topical Mupirocin 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    HICPAP (1994) Recommendations for preventing the spread of vancomycin resistance. Recommendations of the Hospital Infection Control Practices Advisory Committee (HICPAP). MMWR 44: 1–12Google Scholar
  2. 2.
    Smith TL, Pearson ML, Wilcox KR et al (1999) Emergence of vancomycin resistance in Staphylococcus aureus. N Engl J Med 340: 493–501PubMedCrossRefGoogle Scholar
  3. 3.
    Boyce JM, Jackson MM, Pugliese G et al (1994) Methicillin-resistant Staphylococcus aureus (MRSA): a briefing for acute care hospitals and nursing facilities. The AHA technical panel on infections within Hospitals. Infect Control Hosp Epidemiol 15: 105–115Google Scholar
  4. 4.
    Wenzel R, Reagan DR, Bertino JS et al (1998) Methicillin-resistant Staphylococcus aureus outbreak: a consensus panel’s definition and management guidelines. AJIC 26: 102–110Google Scholar
  5. 5.
    Working Party Report (1998) Revised guidelines for the control of methicillin-resistant infection in hospitals. J Hosp Infect 39: 253–290CrossRefGoogle Scholar
  6. 6.
    Barrett SP, Mummery RV (1998) Trying to control MRSA causes more problems than it solves. J Hosp Infect 39: 85–93PubMedCrossRefGoogle Scholar
  7. 7.
    Brun-Buisson C, Legrand P, Rauss A et al (1989) Intestinal decontamination for control of nosocomial multiresistant Gram-negative bacilli. Ann Intern Med 110: 873–881PubMedCrossRefGoogle Scholar
  8. 8.
    Taylor ME, Oppenheim BA (1991) Selective decontamination of the gastrointestinal tract as an infection control measure. J Hosp Infect 17: 271–278PubMedCrossRefGoogle Scholar
  9. 9.
    Fekety R (1997) Guidelines for the diagnosis and management of Chlostridium difficile associated diarrhea and colitis. American College of Gastroenterology, Practice Parameters Committee. Am J Gastroenterol 92: 739–750PubMedGoogle Scholar
  10. 10.
    Crossley K, Landesman B, Zaske D (1979) An outbreak of infections caused by strains of Staphylococcus aureus resistant to methicillin and aminoglycosides. II. Epidemiologic studies. J Infect Dis 139: 280–287Google Scholar
  11. 11.
    Rimland D, Roberson B (1986) Gastrointestinal carriage of methicillin-resistant Staphylococcus aureus. J Clin Microbiol 24: 137–138PubMedCentralPubMedGoogle Scholar
  12. 12.
    Brady LM, Thomson M, Palmer MA, Harkness JL (1990) Successful control of endemic MRSA in a cardiothoracic surgical unit. Med J Aust 152: 240–252PubMedGoogle Scholar
  13. 13.
    Bonten MJM, Hyaden MK, Nathan C et al (1996) Epidemiology of colonisation of patients and environment with vancomycin-resistant enterococci. Lancet 348: 1615–1619Google Scholar
  14. 14.
    Linden PK, Miller CB (1999) Vancomycin-resistant enterococci: the clinical effect of a common nosocomial pathogen. Diagn Microbiol Infect Dis 33: 113–120PubMedCrossRefGoogle Scholar
  15. 15.
    ATS guidelines (1995) Hospital-acquired pneumonia in adults: diagnosis, assessment, initial therapy, and prevention: a consensus statement. Am J Respir Crit Care Med 153: 1711–1725Google Scholar
  16. 16.
    Barlett JG, Breiman RF, Mandell LA, File TM Jr (1998) Community-acquired pneumonia: guidelines for management. Clin Infect Dis 26: 811–838CrossRefGoogle Scholar
  17. 17.
    Tedesco F, Markham R, Gurwith M, et al (1978) Oral vaycomycin for antibiotic associated pseudomembranous colitis. Lancet ií: 226–228Google Scholar
  18. 18.
    Khan MY, Hall WH (1966) Staphylococcal enterocolitis–treatment with oral vancomycin. Ann Intern Med 65: 1–8PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia, Milano 2001

Authors and Affiliations

  • M. A. de la Cal
  • E. Cerdá
  • M. Calderón
  • P. García-Hierro
  • H. K. F. van Saene

There are no affiliations available

Personalised recommendations