A fusidic acid-resistant clone of Staphylococcus aureus associated with impetigo bullosa is spreading in Norway.
OBJECTIVE
To investigate the possibility that the increased prevalence of fusidic acid-resistant Staphylococcus aureus in Norway is caused by clonal spread.


METHODS
Fusidic acid-resistant and -susceptible clinical isolates of S. aureus from patients with skin infections in the Norwegian county of Telemark and fusidic acid-resistant isolates from other parts of Scandinavia were compared. MICs of fusidic acid for bacterial isolates and pulsed-field gel electrophoresis (PFGE) patterns were investigated. Prevalence data for fusidic acid-resistant S. aureus for the period 1992-2001 were obtained.


RESULTS
The prevalence of fusidic acid resistance in S. aureus increased from 1992 to 2001. Eighty per cent of the resistant isolates investigated shared an identical PFGE pattern. The same pattern was found in fusidic acid-resistant isolates from other parts of Scandinavia. Fusidic acid-resistant S. aureus was typically found in impetigo bullosa-like skin disease in children mostly in the summer months.


CONCLUSIONS
Fusidic acid resistance among S. aureus is increasing in Norway and is predominantly caused by one clone of S. aureus. The clone may spread further to other countries, and dissemination may be facilitated by extensive use of topical fusidic acid.
Tveten
Yngvar
Y
Telemark Biomedical Centre, A/S Telelab, Department of Medical Microbiology, Strømdaljordet 4, PO Box 1868, N-3703 Skien, Norway. yngvar.tveten@telelab.no
Jenkins
Andrew
A
Kristiansen
Bjørn-Erik
BE
D002999:Clone Cells; D024881:Drug Resistance, Bacterial / Q000235:genetics*; D005672:Fusidic Acid / Q000494:pharmacology*; D006801:Humans; D007169:Impetigo / Q000188:drug therapy / Q000453:epidemiology / Q000235:genetics*; D009664:Norway / Q000453:epidemiology; D013211:Staphylococcus aureus / Q000235:genetics* / Q000302:isolation & purification
D005672:Fusidic Acid