RESUMEN
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.
Asunto(s)
Antibacterianos/farmacología , Ácido Fusídico/farmacología , Infecciones Estafilocócicas/epidemiología , Infecciones Estafilocócicas/microbiología , Staphylococcus aureus/efectos de los fármacos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Toxinas Bacterianas/química , Tipificación de Bacteriófagos , Niño , Preescolar , Desoxirribonucleasas de Localización Especificada Tipo II/genética , Prescripciones de Medicamentos , Resistencia a Medicamentos , Electroforesis en Gel de Campo Pulsado , Femenino , Genotipo , Humanos , Lactante , Recién Nacido , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Fenotipo , Estudios Retrospectivos , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Gales/epidemiologíaAsunto(s)
Pruebas Diagnósticas de Rutina , Resistencia a la Meticilina , Procedimientos Ortopédicos , Cuidados Preoperatorios , Staphylococcus aureus/aislamiento & purificación , Infección de la Herida Quirúrgica/prevención & control , Adulto , Portador Sano , Procedimientos Quirúrgicos Electivos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Staphylococcus aureus/efectos de los fármacos , GalesAsunto(s)
Hepatitis E/epidemiología , Enfermedad Aguda , Adolescente , Adulto , Egipto/epidemiología , Factores Epidemiológicos , Femenino , Anticuerpos Antihepatitis/sangre , Hepatitis B/complicaciones , Hepatitis B/epidemiología , Hepatitis B/inmunología , Hepatitis C/complicaciones , Hepatitis C/epidemiología , Hepatitis C/inmunología , Hepatitis D/complicaciones , Hepatitis D/epidemiología , Hepatitis D/inmunología , Hepatitis E/complicaciones , Hepatitis E/inmunología , Virus de la Hepatitis E/inmunología , Humanos , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Masculino , Persona de Mediana Edad , Factores de RiesgoRESUMEN
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.