Department of Microbiology, LHUB-ULB, National Reference Centre for Staphylococcus aureus and other species, Université libre de Bruxelles, route de Lennik 808, 1070 Brussels, Belgium.
Centre for Environmental Health and Occupational Health, Public Health School, Université libre de Bruxelles, route de Lennik 808, 1070 Brussels, Belgium.
J Antimicrob Chemother. 2023 Aug 2;78(8):2061-2065. doi: 10.1093/jac/dkad204.
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.
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.
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.
These results suggest the persistence of EEFIC in Belgium. Furthermore, its prevalence may lead to reconsideration of the treatment guidelines for impetigo.
2018 年 8 月，比利时发布了一项公共卫生警报，称金黄色葡萄球菌引起的脓疱疮疫情欧洲耐药性脓疱疮克隆（EEFIC）出现了多起病例。因此，比利时国家参考中心（NRC）受委托更新金黄色葡萄球菌引起社区获得性皮肤和软组织感染（CO-SSTI）的流行病学情况，以评估其中 EEFIC 的比例。
在一年的时间里，比利时临床实验室被要求每月将其首次从 CO-SSTI 中分离出的前三种金黄色葡萄球菌菌株送交到 NRC。对分离株进行药敏试验，检测对苯唑西林、莫匹罗星和夫西地酸的耐药性。耐药分离株还进行 spa 型分析，并检测编码杀白细胞素、毒性休克综合征毒素和表皮剥脱素 A 和 B 的基因的存在情况。MLST 克隆复合体由 spa 型推断得出。
在分析的 518 株金黄色葡萄球菌中，487 株（94.0%）对苯唑西林敏感。其中，79 株（16.2%）对夫西地酸耐药，其中 38 株（48.1%）属于 EEFIC。EEFIC 分离株主要从脓疱疮的年轻患者中分离出来，且具有夏季末的季节性高峰。
这些结果表明 EEFIC 在比利时仍然存在。此外，其流行率可能需要重新考虑脓疱疮的治疗指南。
