Persistence of the Staphylococcus aureus epidemic European fusidic acid-resistant impetigo clone (EEFIC) in Belgium

Abstract Objectives In August 2018, a public health alert was issued in Belgium regarding clusters of impetigo cases caused by the epidemic European fusidic acid-resistant impetigo clone (EEFIC) of Staphylococcus aureus. As a result, the Belgian national reference centre (NRC) was commissioned to up...

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Published in:Journal of antimicrobial chemotherapy 2023-08, Vol.78 (8), p.2061-2065
Main Authors: Deplano, Ariane, Hallin, Marie, Bustos Sierra, Natalia, Michel, Charlotte, Prevost, Benoit, Martiny, Delphine, Yin, Nicolas
Format: Article
Language:English
Subjects:
Anti-Bacterial Agents - pharmacology
Anti-Bacterial Agents - therapeutic use
Belgium - epidemiology
Clone Cells
Drug Resistance, Bacterial - genetics
Fusidic Acid - pharmacology
Humans
Impetigo - drug therapy
Impetigo - epidemiology
Methicillin-Resistant Staphylococcus aureus
Multilocus Sequence Typing
Original Research
Oxacillin
Staphylococcal Infections - drug therapy
Staphylococcal Infections - epidemiology
Staphylococcus aureus
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Summary:Abstract Objectives In August 2018, a public health alert was issued in Belgium regarding clusters of impetigo cases caused by the epidemic European fusidic acid-resistant impetigo clone (EEFIC) of Staphylococcus aureus. As a result, the Belgian national reference centre (NRC) was commissioned to update the epidemiology of S. aureus causing community-onset skin and soft tissues infection (CO-SSTI) to assess the proportion of EEFIC among them. Methods For 1 year, Belgian clinical laboratories were asked to send their first three S. aureus isolated from CO-SSTI each month. Isolates were tested for antimicrobial susceptibility to oxacillin, mupirocin and fusidic acid. Resistant isolates were also spa typed and tested for the presence of the genes encoding the Panton–Valentine leucocidin, the toxic shock syndrome toxin and the exfoliatins A and B. MLST clonal complexes were deduced from the spa types. Results Among the 518 S. aureus strains analysed, 487 (94.0%) were susceptible to oxacillin. Of these, 79 (16.2%) were resistant to fusidic acid, of which 38 (48.1%) belonged to the EEFIC. EEFIC isolates were mostly isolated from young patients with impetigo and showed a seasonal late summer peak. Conclusions These results suggest the persistence of EEFIC in Belgium. Furthermore, its prevalence may lead to reconsideration of the treatment guidelines for impetigo.
ISSN:0305-7453
1460-2091
DOI:10.1093/jac/dkad204