Fusidic Acid Resistance in
            <i>Staphylococcus Aureus</i>
            Nasal Carriage Strains in Nine European Countries

Heijer, Casper D. J. den; Bijnen, E.M.E. van; Paget, W J; Stobberingh, Ellen E.

doi:10.2217/fmb.14.36

Cited by 13 publications

(11 citation statements)

References 26 publications

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“…These findings can indicate the role of limited and appropriate use of vancomycin, proper antibiotic management and clear prescription protocols in Iranian hospitals. Although resistance to fusidic acid among MRSA isolates has been pointed out by several researchers, similar to studies conducted by Aschbacher et al (15) in Italy and Otokunefor et al (20) in the UK, our results showed that none of the investigated isolates was resistant to fusidic acid, which reflects the fact that fusidic acid could be an appropriate choice for the treatment of wound infections associated with S. aureus (21).…”

Section: Discussionsupporting

confidence: 89%

Molecular Analysis and Integron Carriage of Mupirocin-Resistant Staphylococcus aureus Strains Isolated from Burn Wound Infections, Tehran, Iran

Navidinia

Goudarzi

Pouriran

et al. 2019

Arch Clin Infect Dis

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Background:The prevalence of wound infections associated with multidrug-resistant Staphylococcus aureus (S. aureus) strains among burns patients has tremendously increased. Recently, the role of integrons as a key system involved in spreading multi-drug resistance has been well documented. Objectives: To investigate the prevalence of integrons, antimicrobial resistance pattern, and S. aureus protein A (spa) typing of the mupirocin-resistant S. aureus (MRSA) strains obtained from a referral burns hospital in Tehran, Iran. on 64 MRSA isolates gathered from burns patients. The isolates were examined for susceptibility to antimicrobial agents. The integrase-encoding gene was detected by conventional polymerase chain reaction (PCR). Integrase-positive strains were evaluated for the determination of integron classes by using PCR-restriction fragment length polymorphism assay, and genotyping was performed by spa typing. Results: Out of 64 MRSA strains, 24 (37.5%) and 40 (62.5%) isolates carried high-level and low-level resistance, respectively. The findings revealed that the entire isolates were MRSA. They belonged to six different spa types including t860 (40.6%), t790 (21.8%), t037 (17.2%), t064 (17.2%), t008 (1.6%), and t631 (1.6%). Class 1 and 2 integrons were found in 59.4% and 17.2% of the isolates, respectively, and 4 (6.2%) isolates were observed to carry class 1 and 2 integrons simultaneously. Conclusions: Precise epidemiological monitoring of integrons is required to prevent mupirocin resistance dissemination in MRSA strains.

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Section: Discussionsupporting

confidence: 89%

Molecular Analysis and Integron Carriage of Mupirocin-Resistant Staphylococcus aureus Strains Isolated from Burn Wound Infections, Tehran, Iran

Navidinia

Goudarzi

Pouriran

et al. 2019

Arch Clin Infect Dis

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“…The size of the nodes represents the number of isolates included in that type Patients with hand eczema in Östergötland County are rarely treated with antibiotics, systemically or locally, which is reflected in the low prevalence of resistance and resistance genes in S. aureus isolated from patients. The fusidic acid resistant t127/CC1 clone colonizing three patients in our study has previously been frequently isolated around the globe [33][34][35].…”

Section: Discussionmentioning

confidence: 69%

Staphylococcus aureus colonization related to severity of hand eczema

Mernelius

Carlsson

Henricson

et al. 2016

Eur J Clin Microbiol Infect Dis

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Knowledge on Staphylococcus aureus colonization rates and epidemiology in hand eczema is limited. The aim of this study was to clarify some of these issues. Samples were collected by the "glove juice" method from the hands of 59 patients with chronic hand eczema and 24 healthy individuals. Swab samples were taken from anterior nares and throat from 43 of the 59 patients and all healthy individuals. S. aureus were spa typed and analysed by DNA-microarray-based genotyping. The extent of the eczema was evaluated by the hand eczema extent score (HEES). The colonization rate was higher on the hands of hand eczema patients (69 %) compared to healthy individuals (21 %, p < 0.001). This was also seen for bacterial density (p = 0.002). Patients with severe hand eczema (HEES ≥ 13) had a significantly higher S. aureus density on their hands compared to those with milder eczema (HEES = 1 to 12, p = 0.004). There was no difference between patients and healthy individuals regarding colonization rates in anterior nares or throat. spa typing and DNA-microarray-based genotyping indicated certain types more prone to colonize eczematous skin. Simultaneous colonization, in one individual, with S. aureus of different types, was identified in 60-85 % of the study subjects. The colonization rate and density indicate a need for effective treatment of eczema and may have an impact on infection control in healthcare.

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“…Although fusidic acid is not in clinical use in the USA, resistance has been reported (Jones et al 2011). In the APRES study, fusidic acid resistance was detected in 2.8 % (range: 0.1 % to 7.8 %) of the European S. aureus isolates (den Heijer et al 2014). figure 4.…”

Section: Fusidic Acid Resistancementioning

confidence: 97%

“…This is probably due to the restrictive antibiotic prescription policy in Sweden. (den Heijer et al 2013;den Heijer et al 2014) In paper III, 32 erythromycin-resistant isolates were detected, of which 30 (94 %) exhibited inducible clindamycin resistance, the other 2 (6 %) were clindamycin-susceptible. The prevalence of inducible clindamycin resistance varies greatly in different studies (Siberry et al 2003;Vandana et al 2009).…”

Section: S Aureus Epidemiology Antibiotic Resistance (Papers I and Iii)mentioning

confidence: 99%

Infection control of Staphylococcus aureus : spa typing to elucidate transmission

Mernelius¹

2015

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Staphylococcus aureus is a commensal of the human flora, primarily colonizing the anterior nares and throat, but it may also cause infections ranging from mild skin and soft tissue infections to severe diseases such as endocarditis and septicemia. S. aureus is also a major nosocomial problem increasing with the worldwide dissemination of methicillin-resistant S. aureus (MRSA).The main vector for bacterial cross-transmission in healthcare settings is the hands of healthcare workers (HCWs). No S. aureus was detected in the air in this thesis demonstrating that transmission through air is not important. Despite the fact that good compliance with hand hygiene is essential to prevent cross-transmission the compliance is generally less than 50 %.Gold standard to track bacterial transmission in healthcare settings has for long been pulsedfield gel electrophoresis (PFGE), a method that is labor-intensive, lacks consensus protocol and relies on semi-subjective analysis. Molecular typing by sequencing of the hypervariable part of the S. aureus protein A gene (spa typing) has overcome these problems and has shown promising results in epidemiological investigations.The aims of this thesis were to study bacterial transmission with S. aureus colonization of newborn infants as a model and to evaluate spa typing as a molecular tool. Additionally, the influence of compliance with hygiene guidelines on S. aureus transmission was assessed.Analysis of 280 MRSA isolates by spa typing revealed excellent typeability and epidemiological concordance and satisfactory discriminatory power. Additionally, spa typing was considered superior to PFGE thanks to its accessibility, ease of use and rapidity. Also, spa typing results are registered in a global database, facilitating inter-laboratory comparison.The prevalence of S. aureus ranged from 41 % to 66 % in the populations studied and males had the highest colonization rate. Throat was the premier colonization site for adults and transmission from individuals colonized in the throat only was documented, suggesting that throat cultures should be included in S. aureus screening programs. The umbilicus was the premier colonization site for newborn infants. Incubating the swabs in enrichment broth prior to plating increased the prevalence of S. aureus positive samples by 46 %, resulting in prevalence viii ranging from 51 % to 70 % in the populations studied. Thus enrichment prior to plating is necessary to determine more truthful S. aureus colonization rates. There were no indications of an institutional flora, as the colonization rates, spa type distribution and antibiotic resistance prevalence were similar among parents and HCWs.Direct observations and self-reporting by HCWs were both validated as tools for monitoring compliance with hygiene guidelines. The compliance with hygiene guidelines was significantly higher following a 10-point hygiene intervention as compared to baseline. The compliance was also higher three years after the intervention in three of four participating departm...

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Fusidic Acid Resistance in Staphylococcus Aureus Nasal Carriage Strains in Nine European Countries

Abstract: S. aureus strains showed low resistance to fusidic acid, making this antibiotic an appropriate choice in the treatment of methicillin-susceptible S. aureus skin infections in general practice patients in the nine participating European countries.

Cited by 13 publications

References 26 publications

Molecular Analysis and Integron Carriage of Mupirocin-Resistant Staphylococcus aureus Strains Isolated from Burn Wound Infections, Tehran, Iran

Molecular Analysis and Integron Carriage of Mupirocin-Resistant Staphylococcus aureus Strains Isolated from Burn Wound Infections, Tehran, Iran

Staphylococcus aureus colonization related to severity of hand eczema

Infection control of Staphylococcus aureus : spa typing to elucidate transmission

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