Analysis of Antibiotic Susceptibilities of Skin Wound Flora in Hospitalized Dermatology Patients

Background: Results of an ongoing surveillance of antibiotic resistance in hospitalized dermatology patients are presented.Bacterial isolates cultured from patients with skin wounds admitted to a tertiary care dermatology inpatient unit from May 1995 through May 1996 were evaluated for resistance to commonly used antibiotics.Comparison was made with a previous survey of the same inpatient service from 1992.Our results show an alarming trend toward antibiotic resistance.Observation: In superficial skin wounds, Staphylococcus aureus constituted 77% of isolates.In leg ulcers, the frequencies of S aureus and Pseudomonas aeruginosa were approximately equal, constituting 43% and 42% of cultures, respectively.Fifty percent of S aureus isolates from leg ulcers were resistant to oxacillin, with 36% of pseudomonad isolates resistant to ciprofloxacin.In superfi-cial wounds, oxacillin resistance in S aureus approached 25%.A comparison of antibiotic resistance profiles using data collected in 1992 for patients admitted to the same inpatient service revealed a marked increase in oxacillin and ciprofloxacin resistance in S aureus and P aeruginosa in leg ulcers, respectively (from 24% to 50% oxacillin resistance in S aureus and from 9% to 24% ciprofloxacin resistance in P aeruginosa), and superficial wounds (24% to 36% ciprofloxacin resistance in P aeruginosa).Conclusions: This study demonstrates the rapid emergence of antibiotic-resistant bacteria as a problem of growing significance in hospital dermatology and highlights the importance of local surveillance programs to aid in selecting antibiotic treatments.