Antibiotic Resistant Staph Identified In Patient's Death - First Case of Staphylococcus Aureus with Intermediate Resistance to Vancomycin in State
Albany, April 23, 1998 – The State Health Department has identified the first New York case of Staphylococcus aureus infection with intermediate resistance to the antibiotic vancomycin, State Health Commissioner Barbara A. DeBuono, M.D. reported today.
The patient, who had very serious pre–existing medical problems, died from the staph infection last month at United Hospital Medical Center in Port Chester, Westchester County.
"A joint investigation of this case by the State Health Department and hospital personnel confirms that the patient entered the hospital infected with this organism. Our investigation also confirms that the antibiotic–resistant organism was not transmitted to others," Commissioner DeBuono said.
Family members, health care workers and other patients who had any direct contact with the infected patient have been tested, and none has been found to be infected with the vancomycin resistant bacteria. A total of 38 individuals were tested; all were negative.
"The appearance of Staphylococcus aureus with intermediate resistance to vancomycin in New York is not unexpected, since other cases have occurred in the U.S.," Dr. DeBuono said. "This isolated case does not pose a risk to the public, but it does alert health professionals to the need to reduce overuse of antibiotics and to follow stringent infection control practices at all times."
This represents only the third case of Staphylococcus aureus with intermediate resistance to vancomycin (known as VISA) identified in the U.S. Two prior cases occurred in 1997, one in a Michigan resident, and one in a New Jersey patient. A case also was reported in 1996 in a patient in Japan. All of these patients survived the infection after receiving other drug therapies, and no spread of the disease to others was identified in any of the cases.
The State Health Department has established a statewide monitoring system to rapidly identify vancomycin–resistant Staphylococcus organisms within New York, and to conduct follow–up investigation. CDC guidelines for the prevention and control of vancomycin– resistant Staphylococcus aureus were provided to all hospitals in August 1997 by the State Health Department.
United Hospital Medical Center promptly reported this case to the State Health Department and cooperated fully in the investigation. Cultures from the patient were tested by the Health Department's Wadsworth Laboratory to confirm intermediate vancomycin resistance. Further confirmatory tests also were performed by the federal Centers for Disease Control.
Hospitals and kidney dialysis facilities are being notified of the confirmed case of VISA by the State Health Department and Westchester County Health Department.
Staphylococci bacteria are one of the most common causes of community and hospital acquired infection. Since the 1980's, vancomycin has been used increasingly to treat serious staph infections, because the organisms have become resistant to most other available drugs.