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Postoperative enteritis caused by methicillin-resistant Staphylococcus aureus.

T Kodama·T Santo·T Yokoyama·Y Takesue·E Hiyama·Y Imamura·Y Murakami·H Tsumura·K Shinbara·N Tatsumoto·Y Matsuura
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Abstract

We examined the clinical features of 14 men (mean age 72 years) with postoperative enteritis caused by methicillin-resistant Staphylococcus aureus (MRSA). The patients had all undergone surgery for the treatment of digestive diseases and had received antibiotic prophylaxis consisting of an extended-spectrum cephem. Diarrhea appeared a mean of 3.3 days postoperatively and lasted for 5 days on average. In severe cases organ insufficiency was involved. Coagulate-positive staphylococci were the predominant organisms isolated from watery diarrhea. In 13 of 14 patients, coagulase type II isolates producing enterotoxins A, C and toxic shock syndrome toxin-1 (TSST-1) with enterotoxin A, C, and 1st genes were isolated. These strains were sensitive to vancomycin and arbekacin; however, they were highly resistant to many other antibiotics. We also investigated the effects of a glucocorticoid hormone and gamma globulin on production of tumor necrosis factor-alpha (TNF-alpha) and interleukin-2 (IL-2) obtained from healthy volunteers. TNF-alpha and IL-2 production was enhanced by TSST-1 and the supernatant of Iscove-modified dulbecco medium, in which coagulase type II isolates producing enterotoxins A, C and TSST-1 with enterotoxin A, C were cultured for 24 h. Both glucocorticoid hormone and gamma globulin suppressed TNF-alpha and IL-2 production, thus suggesting that these drugs may be effective in treating postoperative MRSA enteritis.

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AgedAged, 80 and overAnti-Bacterial AgentsDibekacinDigestive System DiseasesEnteritisEnterotoxinsGlucocorticoidsHumansImmunoglobulin GIn Vitro TechniquesInterleukin-2MaleMethicillin ResistanceMiddle AgedPostoperative ComplicationsShock, SepticStaphylococcal InfectionsStaphylococcus aureusTumor Necrosis Factor-alphaVancomycinJournal Article

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T Kodama, T Santo, T Yokoyama, Y Takesue, E Hiyama, Y Imamura, Y Murakami, H Tsumura, K Shinbara, N Tatsumoto, Y Matsuura. 1997. Postoperative enteritis caused by methicillin-resistant Staphylococcus aureus.. https://doi.org/10.1007/bf02385272

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