Ce travail decrit deux phenomenes epidemiques a Staphylococcus aureus de sensibilite diminuee aux glycopeptides, l'un en 2000 avec huit patients concernes et l'autre en 2001-2002 avec 16 patients. Le depistage systematique de ces souches aux laboratoires de bacteriologie de notre hopital a permis de les detecter rapidement. Le caractere clonal de ces souches a ete confirme par electrophorese en champ pulse. La gestion de ces phenomenes epidemiques a confirme (i) la necessite de l'application systematique des precautions standards, (ii) l'importance de la transmission d'informations pour lutter contre les bacteries multiresistantes mais egalement la difficulte de transfert dans un autre service des patients colonises et (iii) le caractere intermittent du portage de S. aureus, ce qui necessite une surveillance prolongee des patients colonises et/ou infectes. De plus cette etude souligne l'interet d'une prise en charge multidisciplinaire de la diffusion des bacteries multiresistantes.
This study describes two epidemic outbreaks involving Staphylococcus aureus with reduced sensitivity to glycopeptides, one in 2000 involving eight patients and the other in 2001-2002 involving 16 patients. These strains were detected rapidly, thanks to routine screening for the offending organisms in the bacteriology laboratory of our hospital. The clonal character of these strains was confirmed by pulsed field electrophoresis. The management of these epidemic outbreaks confirmed (i) the need for systematic adoption of standard precautions, (ii) the importance of circulating information in combating multi-resistant bacteria, as well as the difficulties in transferring colonised patients to different hospital wards, and (iii) the intermittent nature of S. aureus carriage, resulting in a need for prolonged surveillance of colonised and/or infected patients. In addition, our study underlines the value of a multi-disciplinary approach to the management of diffusion of multi-resistant bacteria.