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Glucose, bronchial secretions and MRSA
  1. J S Brown
  1. Correspondence to:
    Dr J S Brown
    Centre for Respiratory Research, Department of Medicine, Royal Free and University College Medical School, Rayne Institute, London WC1E 6JJ, UK; jeremy.brownucl.ac.uk

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Association of MRSA infection with abnormal glucose levels in respiratory tract secretions

Strains of Staphylococcus aureus resistant to first line antibiotic therapy (the penicillinase resistant penicillins cloxacillin, flucloxacillin and methicillin), termed methicillin resistant S aureus (MRSA), first appeared in 1961 and are now widespread worldwide.1 In the UK MRSA is particularly prevalent, especially on intensive care wards, causing a variety of important nosocomial infections. Infection with MRSA usually requires parenteral therapy with a glycopeptide antibiotic and frequently substantially prolongs the patient’s hospital admission. Isolation of carriers places considerable stress on available bed resources and local outbreaks can even result in temporary ward closures. As a consequence, the human and financial burden of MRSA is significant, and this is reflected by the adoption of improved control of hospital acquired infections by a major political party as a major election “pledge”.

The paper by Philips et al2 in this issue of Thorax reports a possible association between a positive culture for MRSA from bronchial aspirates from patients in an intensive care ward and abnormally high levels of glucose in the bronchial aspirates (ranging from 2.7 to 4.4 mmol/l). MRSA infection was just over twice as likely in patients with abnormal glucose levels in bronchial aspirates, but the overall incidence of 45% for isolation of MRSA from the respiratory tract is surprisingly high and may limit the applicability of these results to other hospitals. However, if the association of MRSA with abnormal …

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