Rørtveit Sverre, Skutlaberg Dag Harald, Langeland Nina, Rortveit Guri
From the Municipal Health Services of Austevoll , Bekkjarvik.
Scand J Infect Dis. 2014 Dec;46(12):832-7. doi: 10.3109/00365548.2014.947317. Epub 2014 Sep 17.
From around the year 2000, Northern Europe experienced a rise in impetigo caused by Staphylococcus aureus resistant to fusidic acid. A single clone of S. aureus was found to be the bacterial pathogen involved in the impetigo outbreak in Norway, Sweden, the UK and Ireland, termed 'the epidemic European fusidic acid-resistant impetigo clone' (EEFIC). We have followed the incidence of impetigo during the years 2001-2012 based on all patients in general practice in the island community of Austevoll, Western Norway. We previously reported a marked decline of impetigo incidence in Austevoll, from 0.0260 cases per person-year in 2002 to 0.0038 in 2009. This article explores indications of an end to the impetigo epidemic caused by the EEFIC clone.
All four general practitioners (GPs) in the community (mean population = 4400) were asked to diagnose impetigo in a uniform way and to take bacterial specimens from all impetigo cases. Phenotypic characteristics of specimen bacteria were determined for the whole period and molecular analyses were performed on isolates in the period 2008-2012.
We observed a further decline in incidence of impetigo in Austevoll in the study period. The proportion of fusidic acid-resistant S. aureus isolates decreased during the period 2002-2012, with a mean of 80% in the epidemic years of 2002-2004, 55% in 2005-2009, and 6% in 2010-2012. In total, 44 S. aureus isolates from impetigo were subject to molecular analyses in the period 2008-2012, and 11 were found to be related to the EEFIC. All EEFIC isolates were found in 2008-2009, with no new isolates in 2010-2012.
There is an apparent end to the impetigo epidemic related to the EEFIC in this population in Western Norway.
从2000年左右开始，北欧由对夫西地酸耐药的金黄色葡萄球菌引起的脓疱病有所增加。在挪威、瑞典、英国和爱尔兰的脓疱病暴发中发现单一的金黄色葡萄球菌克隆是致病细菌病原体，称为“流行的欧洲夫西地酸耐药脓疱病克隆”（EEFIC）。我们基于挪威西部奥斯特沃尔岛社区全科医疗中的所有患者，追踪了2001年至2012年期间脓疱病的发病率。我们之前报道过奥斯特沃尔岛脓疱病发病率显著下降，从2002年的每人每年0.0260例降至2009年的0.0038例。本文探讨了EEFIC克隆引起的脓疱病流行结束的迹象。
要求该社区的所有四名全科医生（平均人口=4400）以统一方式诊断脓疱病，并从所有脓疱病病例中采集细菌样本。确定了整个时期样本细菌的表型特征，并对2008年至2012年期间的分离株进行了分子分析。
在研究期间，我们观察到奥斯特沃尔岛脓疱病发病率进一步下降。2002年至2012年期间，对夫西地酸耐药的金黄色葡萄球菌分离株比例下降，在2002年至2004年的流行年份平均为8%，2005年至2009年为55%，2010年至2012年为6%。2008年至2012年期间，总共对44株来自脓疱病的金黄色葡萄球菌分离株进行了分子分析，其中11株被发现与EEFIC有关。所有EEFIC分离株均在2008年至2009年发现，2010年至2012年没有新的分离株。
在挪威西部的这一人群中，与EEFIC相关的脓疱病流行明显结束。
