High rate of methicillin resistance of Staphylococcus aureus isolated from hospitalized nursing home patients.

Three series of studies were conducted between 1984 and 1986 at two community hospitals in Chicago to determine the frequency of methicillin resistance of Staphylococcus aureus isolated from hospitalized nursing home patients. Overall, 76 (49%) of 155 patients with S aureus clinical isolates admitted from 25 nursing homes had methicillin-resistant S aureus. In 1986, 53.1% of patients with S aureus infection or colonization among nursing home patients had the resistant strain, in contrast with 13.2% among patients from the community. A high incidence of methicillin-resistant S aureus infection or colonization is a clinical feature of nursing home patients. This observation may lead to an improvement in the clinical management of the patients suspected of having S aureus infection and alterations in the current policy of nursing homes that bar admission of patients carrying the resistant bacteria.

Endoprosthesis implantation in the treatment of recurrent urethral stricture: a multicenter study. Sicilian-Calabrian Urology Society.

PURPOSE: This study was conducted by nine urology departments in southern Italy to assess the efficacy of and tolerance to treatment of recurrent urethral stricture using a permanent prosthesis. PATIENTS AND METHODS: Since 1992, 99 prostheses have been implanted to treat inflammatory and iatrogenic (seven departments) or all types (two departments) of urethral strictures. The Urolume Wallstent was used in 94 cases. Three centers implanted more than one prosthesis when this was indicated. Local anesthesia was used by six centers, spinal anesthesia by two, and local or general by one. At three centers, urethrotomy was performed immediately prior to implantation; two centers used dilation to 30F, and two centers performed urethrotomy 24 or 36 hours before implantation. The median follow-up is 29.1 months (range 3-53 months). RESULTS: The results were good in 52%, fair in 34%, and poor in 14% of patients. The maximum flow rate increased >75% in 82% of patients. All departments reported complete reepithelialization of the urethra by 6 months. The short-term complications (7-28 days) were perineal discomfort (86%) and dribbling (14%). The long-term complications were painful erection (44%), mucous hyperplasia (44%), recurring stricture (29%), and incontinence (14%). All departments performed resection for hyperplasia in many cases. CONCLUSION: Permanent urethral endoprostheses can produce excellent results in patients with recurrent urethral strictures.