ABSTRACT
OBJECTIVE: This retrospective study was designed to investigate the possible reasons for an apparent increase in fusidic acid resistance among Staphylococcus aureus. MATERIALS AND METHODS: The Datastore records of the Communicable Disease Surveillance Centre, Wales, UK were reviewed in conjunction with information concerning the prescribing of fusidic acid. RESULTS: During the 5 year study period (1997-2001), a rise in the incidence of fusidic acid resistance was noted, particularly among paediatric patients presenting with infected eczema and impetigo, which may be related to the observed increase in prescriptions of topical fusidic acid. Extended phenotypic and genotypic characterization of a limited number (n=31) of isolates from 2002 showed that fusidic acid-resistant strains of S. aureus were typically from patients with impetigo and isolates fell into a single clonal group. Conversely, isolates from other skin disease (eczema, dermatitis and abscesses) were usually susceptible to fusidic acid and proved a diverse group. CONCLUSION: This study provides valuable data on the prevalence of fusidic acid-resistant S. aureus, the genetic background of the strains, and their association with clinical disease in both the healthcare environment and community setting in the catchment area served by the Laboratory.
Subject(s)
Anti-Bacterial Agents/pharmacology , Fusidic Acid/pharmacology , Staphylococcal Infections/epidemiology , Staphylococcal Infections/microbiology , Staphylococcus aureus/drug effects , Adolescent , Adult , Aged , Aged, 80 and over , Bacterial Toxins/chemistry , Bacteriophage Typing , Child , Child, Preschool , Deoxyribonucleases, Type II Site-Specific/genetics , Drug Prescriptions , Drug Resistance , Electrophoresis, Gel, Pulsed-Field , Female , Genotype , Humans , Infant , Infant, Newborn , Male , Microbial Sensitivity Tests , Middle Aged , Phenotype , Retrospective Studies , Reverse Transcriptase Polymerase Chain Reaction , Wales/epidemiologySubject(s)
Diagnostic Tests, Routine , Methicillin Resistance , Orthopedic Procedures , Preoperative Care , Staphylococcus aureus/isolation & purification , Surgical Wound Infection/prevention & control , Adult , Carrier State , Elective Surgical Procedures , Female , Humans , Male , Middle Aged , Staphylococcus aureus/drug effects , WalesSubject(s)
Hepatitis E/epidemiology , Acute Disease , Adolescent , Adult , Egypt/epidemiology , Epidemiologic Factors , Female , Hepatitis Antibodies/blood , Hepatitis B/complications , Hepatitis B/epidemiology , Hepatitis B/immunology , Hepatitis C/complications , Hepatitis C/epidemiology , Hepatitis C/immunology , Hepatitis D/complications , Hepatitis D/epidemiology , Hepatitis D/immunology , Hepatitis E/complications , Hepatitis E/immunology , Hepatitis E virus/immunology , Humans , Immunoglobulin G/blood , Immunoglobulin M/blood , Male , Middle Aged , Risk FactorsABSTRACT
A study was conducted to determine the etiology of acute hepatitis among 261 children (age range 1-11 years) living in Cairo, Egypt. A blood sample was obtained from each subject when initially evaluated and a questionnaire was used to collect demographic and risk factor data. Sera were tested by enzyme immunoassay for acute hepatitis A (anti-hepatitis A virus IgM), hepatitis B (anti-hepatitis B core antigen IgM and hepatitis B surface antigen [HBsAg]), hepatitis C (total anti-HCV), delta hepatitis (total anti-delta), and cytomegalovirus infection (anti-CMV IgM). In addition, hepatitis E virus (HEV) infection was diagnosed using a new Western blot technique to test patients with non-A, non-B hepatitis for anti-HEV IgM. Among 261 children, acute hepatitis A was diagnosed in 85 (32.6%) patients, acute hepatitis B in 19 (7.3%), delta hepatitis in 3 (1.1%), mixed hepatitis A and B infection in 2 (0.8%), CMV infection in 1 (0.4%), hepatitis E in 58 (22.2%), and non-A, non-B hepatitis of unknown type in 51 (19.5%). Forty-two (16.1%) subjects had HBsAg without other markers of acute infection. Risk factor analysis indicated that patients living in homes not connected to a municipal source of water were at increased risk of hepatitis E infection. These data provide additional evidence that hepatitis E virus is a common cause of acute sporadic hepatitis in children living in Egypt.
