title: A fusidic acid-resistant clone of Staphylococcus aureus associated with impetigo bullosa is spreading in Norway.
abstract: 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.
authors.affiliation: Telemark Biomedical Centre, A/S Telelab, Department of Medical Microbiology, Strømdaljordet 4, PO Box 1868, N-3703 Skien, Norway. yngvar.tveten@telelab.no
authors.forename: Yngvar
authors.initials: Y
authors.lastname: Tveten
authors.forename: Andrew
authors.initials: A
authors.lastname: Jenkins
authors.forename: Bjørn-Erik
authors.initials: BE
authors.lastname: Kristiansen
mesh_terms: 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
chemical_list: D005672:Fusidic Acid