An unusual outbreak in the Netherlands: community-onset impetigo caused by a meticillin-resistant Staphylococcus aureus with additional resistance to fusidic acid, June 2018 to January 2020
In this retrospective observational study, we analysed a community outbreak of impetigo with meticillin-resistant (MRSA), with additional resistance to fusidic acid (first-line treatment). The outbreak occurred between June 2018 and January 2020 in the eastern part of the Netherlands with an epidemi...
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| Veröffentlicht in: | Euro surveillance : bulletin européen sur les maladies transmissibles 2022-12, Vol.27 (49), p.1 |
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| creator | Vendrik, Karuna E W Kuijper, Ed J Dimmendaal, Marieke Silvis, Welmoed Denie-Verhaegh, Els de Boer, Annemarie Postma, Bent Schoffelen, Annelot F Ruijs, Wilhelmina L M Koene, Fleur M H P A Petrignani, Mariska Hooiveld, Mariëtte Witteveen, Sandra Schouls, Leo M Notermans, Daan W |
| description | In this retrospective observational study, we analysed a community outbreak of impetigo with meticillin-resistant
(MRSA), with additional resistance to fusidic acid (first-line treatment). The outbreak occurred between June 2018 and January 2020 in the eastern part of the Netherlands with an epidemiological link to three cases from the north-western part. Forty nine impetigo cases and eight carrier cases were identified, including 47 children. All but one impetigo case had community-onset of symptoms. Pharmacy prescription data for topical mupirocin and fusidic acid and GP questionnaires suggested an underestimated outbreak size. The 57 outbreak isolates were identified by the Dutch MRSA surveillance as MLVA-type MT4627 and sequence type 121, previously reported only once in 2014. Next-generation sequencing revealed they contained a fusidic acid resistance gene, exfoliative toxin genes and an epidermal cell differentiation inhibitor gene. Whole-genome multilocus sequence typing revealed genetic clustering of all 19 sequenced isolates from the outbreak region and isolates from the three north-western cases. The allelic distances between these Dutch isolates and international isolates were high. This outbreak shows the appearance of community-onset MRSA strains with additional drug resistance and virulence factors in a country with a low prevalence of antimicrobial resistance. |
| doi_str_mv | 10.2807/1560-7917.ES.2022.27.49.2200245 |
| format | Article |
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(MRSA), with additional resistance to fusidic acid (first-line treatment). The outbreak occurred between June 2018 and January 2020 in the eastern part of the Netherlands with an epidemiological link to three cases from the north-western part. Forty nine impetigo cases and eight carrier cases were identified, including 47 children. All but one impetigo case had community-onset of symptoms. Pharmacy prescription data for topical mupirocin and fusidic acid and GP questionnaires suggested an underestimated outbreak size. The 57 outbreak isolates were identified by the Dutch MRSA surveillance as MLVA-type MT4627 and sequence type 121, previously reported only once in 2014. Next-generation sequencing revealed they contained a fusidic acid resistance gene, exfoliative toxin genes and an epidermal cell differentiation inhibitor gene. Whole-genome multilocus sequence typing revealed genetic clustering of all 19 sequenced isolates from the outbreak region and isolates from the three north-western cases. The allelic distances between these Dutch isolates and international isolates were high. This outbreak shows the appearance of community-onset MRSA strains with additional drug resistance and virulence factors in a country with a low prevalence of antimicrobial resistance.</description><subject>Anti-Bacterial Agents - pharmacology</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Child</subject><subject>Disease Outbreaks</subject><subject>Drug resistance</subject><subject>Epidemics</subject><subject>Fusidic Acid - pharmacology</subject><subject>Fusidic Acid - therapeutic use</subject><subject>Humans</subject><subject>Impetigo</subject><subject>Impetigo - drug therapy</subject><subject>Impetigo - epidemiology</subject><subject>Methicillin</subject><subject>Methicillin-Resistant Staphylococcus aureus</subject><subject>Microbial Sensitivity Tests</subject><subject>Netherlands - epidemiology</subject><subject>Outbreaks</subject><subject>Skin diseases</subject><subject>Staphylococcal Infections - drug therapy</subject><subject>Staphylococcal Infections - epidemiology</subject><subject>Staphylococcus aureus</subject><subject>Staphylococcus infections</subject><issn>1560-7917</issn><issn>1025-496X</issn><issn>1560-7917</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdUk1v1DAQjRAVLYW_gCxxoAcSnHGcxByoqmqhVBUcFs6WYztdl8Re_AHaH8d_w1G3q8LFY3vePI_fvKJ4U-MKety9q2mLy47VXbVaV4ABKuiqhlUAGENDnxQnB8TTR_vj4nkIdxg3BDN4VhyTtmW0afBJ8efComRTSGJCLsXBa_EDGYviRqMvOq9-ElaF90i6eU7WxF3pbNARmXmro7l1SIoUtELDDgk05ytppsnY0utgQhQ2onUU281uctJJmQISyescfpu4QUIpE42z-fEHvNQoOjSmYJSRSEij3qLrZDUCXPdL6lrYJPwunwG_KI5GMQX9ch9Pi-8fV98ur8qbr58-X17clLJpWSyVFCMlDAghAxG0l1INrSQUmrYTUONBdVk-2g31qGnWTMq2B6ZIzwaJRT-S0-LDPe82DbNWUtvoxcS33sy5Fe6E4f9mrNnwW_eLs44AA8gEZ3sC734mHSKfTZB6yuJqlwKHLg8kA4Fm6Ov_oHcu-SzRgqINbRjtcUad36OkdyF4PR6aqTFfrMKX4fNl-Hy15otVcjlvGN9bJTO8evynQ_2DN8hfn8a_GA</recordid><startdate>20221208</startdate><enddate>20221208</enddate><creator>Vendrik, Karuna E W</creator><creator>Kuijper, Ed J</creator><creator>Dimmendaal, Marieke</creator><creator>Silvis, Welmoed</creator><creator>Denie-Verhaegh, Els</creator><creator>de Boer, Annemarie</creator><creator>Postma, Bent</creator><creator>Schoffelen, Annelot F</creator><creator>Ruijs, Wilhelmina L M</creator><creator>Koene, Fleur M H P A</creator><creator>Petrignani, Mariska</creator><creator>Hooiveld, Mariëtte</creator><creator>Witteveen, Sandra</creator><creator>Schouls, Leo M</creator><creator>Notermans, Daan W</creator><general>Centre Europeen pour la Surveillance Epidemiologique du SIDA (European Centre for the Epidemiological Monitoring of AIDS)</general><general>European Centre for Disease Prevention and Control (ECDC)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-9259-4920</orcidid></search><sort><creationdate>20221208</creationdate><title>An unusual outbreak in the Netherlands: community-onset impetigo caused by a meticillin-resistant Staphylococcus aureus with additional resistance to fusidic acid, June 2018 to January 2020</title><author>Vendrik, Karuna E W ; Kuijper, Ed J ; Dimmendaal, Marieke ; Silvis, Welmoed ; Denie-Verhaegh, Els ; de Boer, Annemarie ; Postma, Bent ; Schoffelen, Annelot F ; Ruijs, Wilhelmina L M ; Koene, Fleur M H P A ; Petrignani, Mariska ; Hooiveld, Mariëtte ; Witteveen, Sandra ; Schouls, Leo M ; Notermans, Daan W</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c469t-dcaf5392333b3a58ccdb6c352467a210bd700257b1fe5560cc6829d389bc0a8f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Anti-Bacterial Agents - pharmacology</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Child</topic><topic>Disease Outbreaks</topic><topic>Drug resistance</topic><topic>Epidemics</topic><topic>Fusidic Acid - pharmacology</topic><topic>Fusidic Acid - therapeutic use</topic><topic>Humans</topic><topic>Impetigo</topic><topic>Impetigo - drug therapy</topic><topic>Impetigo - epidemiology</topic><topic>Methicillin</topic><topic>Methicillin-Resistant Staphylococcus aureus</topic><topic>Microbial Sensitivity Tests</topic><topic>Netherlands - epidemiology</topic><topic>Outbreaks</topic><topic>Skin diseases</topic><topic>Staphylococcal Infections - drug therapy</topic><topic>Staphylococcal Infections - epidemiology</topic><topic>Staphylococcus aureus</topic><topic>Staphylococcus infections</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Vendrik, Karuna E W</creatorcontrib><creatorcontrib>Kuijper, Ed J</creatorcontrib><creatorcontrib>Dimmendaal, Marieke</creatorcontrib><creatorcontrib>Silvis, Welmoed</creatorcontrib><creatorcontrib>Denie-Verhaegh, Els</creatorcontrib><creatorcontrib>de Boer, Annemarie</creatorcontrib><creatorcontrib>Postma, Bent</creatorcontrib><creatorcontrib>Schoffelen, Annelot F</creatorcontrib><creatorcontrib>Ruijs, Wilhelmina L M</creatorcontrib><creatorcontrib>Koene, Fleur M H P A</creatorcontrib><creatorcontrib>Petrignani, Mariska</creatorcontrib><creatorcontrib>Hooiveld, Mariëtte</creatorcontrib><creatorcontrib>Witteveen, Sandra</creatorcontrib><creatorcontrib>Schouls, Leo M</creatorcontrib><creatorcontrib>Notermans, Daan W</creatorcontrib><creatorcontrib>MRSA consortium</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Euro surveillance : bulletin européen sur les maladies transmissibles</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Vendrik, Karuna E W</au><au>Kuijper, Ed J</au><au>Dimmendaal, Marieke</au><au>Silvis, Welmoed</au><au>Denie-Verhaegh, Els</au><au>de Boer, Annemarie</au><au>Postma, Bent</au><au>Schoffelen, Annelot F</au><au>Ruijs, Wilhelmina L M</au><au>Koene, Fleur M H P A</au><au>Petrignani, Mariska</au><au>Hooiveld, Mariëtte</au><au>Witteveen, Sandra</au><au>Schouls, Leo M</au><au>Notermans, Daan W</au><aucorp>MRSA consortium</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>An unusual outbreak in the Netherlands: community-onset impetigo caused by a meticillin-resistant Staphylococcus aureus with additional resistance to fusidic acid, June 2018 to January 2020</atitle><jtitle>Euro surveillance : bulletin européen sur les maladies transmissibles</jtitle><addtitle>Euro Surveill</addtitle><date>2022-12-08</date><risdate>2022</risdate><volume>27</volume><issue>49</issue><spage>1</spage><pages>1-</pages><issn>1560-7917</issn><issn>1025-496X</issn><eissn>1560-7917</eissn><abstract>In this retrospective observational study, we analysed a community outbreak of impetigo with meticillin-resistant
(MRSA), with additional resistance to fusidic acid (first-line treatment). The outbreak occurred between June 2018 and January 2020 in the eastern part of the Netherlands with an epidemiological link to three cases from the north-western part. Forty nine impetigo cases and eight carrier cases were identified, including 47 children. All but one impetigo case had community-onset of symptoms. Pharmacy prescription data for topical mupirocin and fusidic acid and GP questionnaires suggested an underestimated outbreak size. The 57 outbreak isolates were identified by the Dutch MRSA surveillance as MLVA-type MT4627 and sequence type 121, previously reported only once in 2014. Next-generation sequencing revealed they contained a fusidic acid resistance gene, exfoliative toxin genes and an epidermal cell differentiation inhibitor gene. Whole-genome multilocus sequence typing revealed genetic clustering of all 19 sequenced isolates from the outbreak region and isolates from the three north-western cases. The allelic distances between these Dutch isolates and international isolates were high. This outbreak shows the appearance of community-onset MRSA strains with additional drug resistance and virulence factors in a country with a low prevalence of antimicrobial resistance.</abstract><cop>Sweden</cop><pub>Centre Europeen pour la Surveillance Epidemiologique du SIDA (European Centre for the Epidemiological Monitoring of AIDS)</pub><pmid>36695440</pmid><doi>10.2807/1560-7917.ES.2022.27.49.2200245</doi><orcidid>https://orcid.org/0000-0002-9259-4920</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Anti-Bacterial Agents - pharmacology Anti-Bacterial Agents - therapeutic use Child Disease Outbreaks Drug resistance Epidemics Fusidic Acid - pharmacology Fusidic Acid - therapeutic use Humans Impetigo Impetigo - drug therapy Impetigo - epidemiology Methicillin Methicillin-Resistant Staphylococcus aureus Microbial Sensitivity Tests Netherlands - epidemiology Outbreaks Skin diseases Staphylococcal Infections - drug therapy Staphylococcal Infections - epidemiology Staphylococcus aureus Staphylococcus infections |
| title | An unusual outbreak in the Netherlands: community-onset impetigo caused by a meticillin-resistant Staphylococcus aureus with additional resistance to fusidic acid, June 2018 to January 2020 |
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