欧洲富西迪耐酸脓疱疮克隆流行导致脓疱疮流行的下降:挪威西部一个社区11.5年基于人群的发病率研究

Sverre Rørtveit, Dag Harald Skutlaberg, Nina Langeland, Guri Rortveit
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引用次数: 7

摘要

背景:大约从2000年开始,北欧经历了脓疱疮的上升,由耐夫西地酸的金黄色葡萄球菌引起。在挪威、瑞典、英国和爱尔兰爆发的脓疱疮爆发中发现了金黄色葡萄球菌的单一克隆细菌病原体,称为“流行的欧洲耐富西地酸脓疱疮克隆”(EEFIC)。我们以挪威西部Austevoll岛社区的全科医生为基础,跟踪了2001-2012年期间脓疱疮的发病率。我们之前报道了澳大利亚脓疱疮发病率的显著下降,从2002年的0.0260例/年下降到2009年的0.0038例/年。本文探讨了由EEFIC克隆引起的脓疱病流行结束的迹象。方法:要求社区4名全科医生(平均4400人)统一诊断脓疱疮,并采集所有脓疱疮病例的细菌标本。对2008-2012年期间分离的细菌标本进行了分子分析,并测定了整个时期的表型特征。结果:在研究期间,我们观察到澳大利亚脓疱疮的发病率进一步下降。2002-2012年期间,耐夫西地酸金黄色葡萄球菌分离株的比例下降,2002-2004年流行年平均为80%,2005-2009年为55%,2010-2012年为6%。2008-2012年共对44株脓疱疮金黄色葡萄球菌进行了分子分析,其中11株与EEFIC相关。2008-2009年发现所有EEFIC分离株,2010-2012年未发现新分离株。结论:在挪威西部的这一人群中,与EEFIC相关的脓疱病流行明显结束。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

The decline of the impetigo epidemic caused by the epidemic European fusidic acid-resistant impetigo clone: an 11.5-year population-based incidence study from a community in Western Norway.

The decline of the impetigo epidemic caused by the epidemic European fusidic acid-resistant impetigo clone: an 11.5-year population-based incidence study from a community in Western Norway.

Background: From around the year 2000, Northern Europe experienced a rise in impetigo caused by Staphylococcus aureus resistant to fusidic acid. A single clone of S. aureus was found to be the bacterial pathogen involved in the impetigo outbreak in Norway, Sweden, the UK and Ireland, termed 'the epidemic European fusidic acid-resistant impetigo clone' (EEFIC). We have followed the incidence of impetigo during the years 2001-2012 based on all patients in general practice in the island community of Austevoll, Western Norway. We previously reported a marked decline of impetigo incidence in Austevoll, from 0.0260 cases per person-year in 2002 to 0.0038 in 2009. This article explores indications of an end to the impetigo epidemic caused by the EEFIC clone.

Methods: All four general practitioners (GPs) in the community (mean population = 4400) were asked to diagnose impetigo in a uniform way and to take bacterial specimens from all impetigo cases. Phenotypic characteristics of specimen bacteria were determined for the whole period and molecular analyses were performed on isolates in the period 2008-2012.

Results: We observed a further decline in incidence of impetigo in Austevoll in the study period. The proportion of fusidic acid-resistant S. aureus isolates decreased during the period 2002-2012, with a mean of 80% in the epidemic years of 2002-2004, 55% in 2005-2009, and 6% in 2010-2012. In total, 44 S. aureus isolates from impetigo were subject to molecular analyses in the period 2008-2012, and 11 were found to be related to the EEFIC. All EEFIC isolates were found in 2008-2009, with no new isolates in 2010-2012.

Conclusion: There is an apparent end to the impetigo epidemic related to the EEFIC in this population in Western Norway.

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