Susceptibility of skin and soft-tissue isolates of Staphylococcus aureus and Streptococcus pyogenes to topical antibiotics: indications of clonal spread of fusidic acid-resistant Staphylococcus aureus

Scand J Infect Dis. 2003;35(2):84-9. doi: 10.1080/0036554021000026980.

Abstract

Staphylococcus aureus (SA) isolates (n = 255) from outpatients with skin and soft-tissue infections were collected in 3 different areas in Norway. Group A streptococci (GAS, n = 68) were isolated from skin or pharyngotonsillar specimens from outpatients. Minimum inhibitory concentrations (MIC) of bacitracin, fusidic acid and mupirocin were tested using the E-test. Pulsed field gel electrophoresis (PFGE) patterns of fusidic acid-sensitive (FusS) and -resistant (FusR) SA were compared. All GAS isolates showed MIC of bacitracin of < or = 1.0 mg/l, of mupirocin of < or = 0.125 mg/l and of fusidic acid 1.0-4.0 mg/l. All the SA showed MIC of mupirocin < or = 0.5 mg/l and of bacitracin of > or = 2.0 mg/l, 91% with MIC > or = 16 mg/l. FusR was shown by 32.5% of the SA strains with similar prevalence rates in 3 different geographical areas of Norway. One particular PFGE pattern (type 1) was shown by 76% of the FusR SA. SA of type 1 belonged to phage group II and produced exfoliative toxins. Thus, the results demonstrated a high prevalence of FusR among SA causing skin infections and that this was mainly due to dissemination of clonally related FusR SA.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Topical
  • Adolescent
  • Adult
  • Anti-Bacterial Agents / pharmacology*
  • Anti-Bacterial Agents / therapeutic use
  • Bacitracin / pharmacology
  • Child
  • Drug Resistance, Bacterial
  • Electrophoresis, Gel, Pulsed-Field
  • Female
  • Fusidic Acid / pharmacology*
  • Genes, Bacterial
  • Humans
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Mupirocin / pharmacology
  • Probability
  • Sensitivity and Specificity
  • Skin Diseases, Bacterial / drug therapy
  • Skin Diseases, Bacterial / microbiology
  • Soft Tissue Infections / drug therapy
  • Soft Tissue Infections / microbiology
  • Staphylococcal Infections / drug therapy
  • Staphylococcus aureus / drug effects
  • Staphylococcus aureus / genetics*
  • Streptococcal Infections / drug therapy
  • Streptococcus pyogenes / drug effects
  • Streptococcus pyogenes / genetics*

Substances

  • Anti-Bacterial Agents
  • Bacitracin
  • Fusidic Acid
  • Mupirocin