Survey, characterization and susceptibility to fusidic acid of Staphylococcus aureus in the Carmarthen area.
OBJECTIVE
This retrospective study was designed to investigate the possible reasons for an apparent increase in fusidic acid resistance among Staphylococcus aureus.


METHODS
The Datastore records of the Communicable Disease Surveillance Centre, Wales, UK were reviewed in conjunction with information concerning the prescribing of fusidic acid.


RESULTS
During the 5 year study period (1997-2001), a rise in the incidence of fusidic acid resistance was noted, particularly among paediatric patients presenting with infected eczema and impetigo, which may be related to the observed increase in prescriptions of topical fusidic acid. Extended phenotypic and genotypic characterization of a limited number (n=31) of isolates from 2002 showed that fusidic acid-resistant strains of S. aureus were typically from patients with impetigo and isolates fell into a single clonal group. Conversely, isolates from other skin disease (eczema, dermatitis and abscesses) were usually susceptible to fusidic acid and proved a diverse group.


CONCLUSIONS
This study provides valuable data on the prevalence of fusidic acid-resistant S. aureus, the genetic background of the strains, and their association with clinical disease in both the healthcare environment and community setting in the catchment area served by the Laboratory.
El-Zimaity
D
D
Microbiology Carmarthenshire, National Public Health Service for Wales, West Wales General Hospital, Carmarthen SA31 2AF, UK.
Kearns
A M
AM
Dawson
S J
SJ
Price
S
S
Harrison
G A J
GA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001427:Bacterial Toxins / Q000737:chemistry; D001434:Bacteriophage Typing; D002648:Child; D002675:Child, Preschool; D015252:Deoxyribonucleases, Type II Site-Specific / Q000235:genetics; D011307:Drug Prescriptions; D004351:Drug Resistance; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D005672:Fusidic Acid / Q000494:pharmacology*; D005838:Genotype; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010641:Phenotype; D012189:Retrospective Studies; D020133:Reverse Transcriptase Polymerase Chain Reaction; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000187:drug effects*; D014852:Wales / Q000453:epidemiology
D000900:Anti-Bacterial Agents; D001427:Bacterial Toxins; D005672:Fusidic Acid; C025651:CCCGGG-specific type II deoxyribonucleases; D015252:Deoxyribonucleases, Type II Site-Specific