Gentamicin-methicillin-resistant Staphylococcus aureus: epidemiology and containment of an outbreak.

An outbreak of gentamicin-methicillin-resistant Staphylococcus aureus (gentamicin-resistant MRSA) which occurred during 1983-84 at the Whittington Hospital, London, is described. This involved a total of 40 patients and staff and was largely confined to a urology ward. Seventeen of the patients had catheter-associated infections, 11 had wound infections and five had simultaneous infections of the urine and wound. Six members of staff and one patient were colonized with gentamicin-resistant MRSA. Vigorous and extensive infection control methods were carried out together with the use of a topical antibacterial nasal cream, mupirocin (pseudomonic acid). Seventeen patients and staff were treated with this agent and all were cleared of the original gentamicin-resistant MRSA. Sixteen patients who were not treated with mupirocin were discharged home still carrying the epidemic strain. Sporadic cases of gentamicin-resistant MRSA still occur at infrequent intervals.