SULE O, BROWN NM, BROWN DF, BURROWS NP; Interscience Conference on Antimicrobial Agents and Chemotherapy (41st : 2001 : Chicago, Ill.).
Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2001 Dec 16-19; 41: abstract no. C2-313.
Addenbrookes Hospital, Cambridge, United Kingdom
BACKGROUND: Studies from areas where fusidic acid (FUS) has been used for nearly 40 years have shown that there is little resistance among clinical isolates, despite its rapid selection in vitro. Increasing use of topical FUS may encourage resistance. METHODS: Lab. resistance data for FUS, methicillin (MET) and mupirocin (MUP) in Staphylococcus aureus were reviewed for 1998-2000. RESULTS: FUS-resistance in isolates from hospitalised patients increased from 3.3% in 1998 (n=1,968) to 7.5% in 2000 (n=2,175). MUP and MET-resistance increased by a smaller extent (MUP 8.4% to 12.1% and MET 46.4% to 51.1%). In isolates from community patients FUS-resistance increased from 4.6% in 1998 (n=2,222) to 17.2% in 2000 (n=2,472). There was a small increase in MUP and MET-resistance from 2.2% to 5.0% and 12.2% to 15.4% respectively. The greatest increase in FUS-resistance was seen in isolates from dermatology outpatients (DOP): 13.4% in 1998 (n=262) to 33.9% in 2000 (n=330). MUP and MET-resistance increased from 5.5% to 10.4% and 5.7% to 10.6% respectively. The FUS MIC was determined in 92 consecutive isolates by agar incorporation (MIC range 2->128 mg/L, mode 8 mg/L). Among DOP patients in 2000, resistance was greatest in younger patients (age <20y 55%, age 20-50y 36.6%, age 50-70y 27.4%, age >70y 13.2%). This age group was most often treated with topical FUS, usually for infected chronic eczema. No systemic FUS was used in DOP. Forty-six of 164 FUS-resistant hospital isolates (28%), but only 9 of 112 FUS-resistant DOP isolates (8%) were also MET-resistant. CONCLUSION: FUS-resistance has increased between 1998-2000, particularly in DOP and community isolates. In DOP the increase in FUS-resistance was independent of MET-resistance.
Publication Types:
Keywords:
- Fusidic Acid
- Humans
- In Vitro
- Microbial Sensitivity Tests
- Mupirocin
- Staphylococcus aureus
Other ID:
UI: 102269721
From Meeting Abstracts