Department of Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Centre, Maastricht, The Netherlands.
J Antimicrob Chemother. 2012 May;67(5):1176-80. doi: 10.1093/jac/dkr590. Epub 2012 Jan 30.
We evaluated the susceptibility to fusidic acid, mupirocin and retapamulin of Staphylococcus aureus isolated from nasal and wound swabs.
The susceptibility to the three agents of S. aureus isolated from general patients in the south of The Netherlands with a skin or soft tissue infection was determined between January 2007 and December 2008. Fusidic acid-resistant isolates were tested for the presence of fusidic acid-resistant genes and compared with the epidemic European fusidic acid-resistant impetigo clone (EEFIC).
Fusidic acid resistance was found in 23% of the nasal and 35% of the wound isolates, the majority (~90%) being fusB positive. Most of the isolates belonged to spa type t171 and were isolated from younger patients. One isolate was retapamulin resistant (MIC 8 mg/L) and two were mupirocin resistant.
The EEFIC clone was relatively highly prevalent among the isolated S. aureus. The usefulness of fusidic acid as first-line agent for the treatment of impetigo is questionable. As mupirocin is used in The Netherlands for eradication of methicillin-resistant S. aureus, it is not an alternative; retapamulin might be useful, but further in vivo studies are warranted.
评估金黄色葡萄球菌从鼻拭子和伤口拭子分离株对夫西地酸、莫匹罗星和瑞他帕林的敏感性。
2007 年 1 月至 2008 年 12 月，检测了来自荷兰南部患有皮肤或软组织感染的普通患者的金黄色葡萄球菌对这三种药物的敏感性。对夫西地酸耐药分离株进行了耐药基因检测，并与流行的欧洲夫西地酸耐药脓疱疮克隆（EEFIC）进行了比较。
鼻拭子分离株中有 23%和伤口分离株中有 35%对夫西地酸耐药，其中绝大多数（约 90%）为 fusB 阳性。大多数分离株属于 spa 型 t171，且分离自年轻患者。1 株对瑞他帕林耐药（MIC8mg/L），2 株对莫匹罗星耐药。
EEFIC 克隆在分离的金黄色葡萄球菌中相对较为普遍。夫西地酸作为脓疱疮一线治疗药物的效用值得怀疑。由于莫匹罗星在荷兰被用于清除耐甲氧西林金黄色葡萄球菌，因此它不是一种替代药物；瑞他帕林可能有用，但需要进一步的体内研究。
