A six-year study by three University of Hawaiʻi at Mānoa researchers indicates that the proportion of antibiotic-resistant staph increased significantly in both hospital-based and free-standing nursing homes throughout the state. The bacteria isolated from patients exhibited high resistance against several commonly used antibiotics, including clindamycin, erythromycin and levofloxacin.
The highest proportion of drug-resistant bacteria was found in long-term care facilities on Oʻahu—perhaps because the residents have more visits to hospitals, where the resistant strains are more common.
The study, reported in the May 2010 issue of Hawaiʻi Medical Journal, also found that staph resistance to some secondary antibiotics varied by geographic area. Hawaiʻi County had the highest resistance in tetracycline (40 percent) but lowest resistance in trimethoprim-sulfamethoxazole (0 percent), for example. In contrast, Kauaʻi County had the highest resistance in trimethoprim-sulfamethoxazole (13 percent) but lowest resistance in tetracycline (5 percent).
Future studies that combine clinical and laboratory data are warranted to better understand the burden of methicillin-resistant infections and the transmission dynamics in this unique population, the authors write.
The study was conducted by Junior Researcher Fenfang Li, Professor Pamela Arnsberger and Professor of Tropical Medicine and Medical Microbiology F. DeWolfe Miller. Li and Arnsberger are with the Myron B. Thompson School of Social Work; Miller is with the John A. Burns School of Medicine.