Fusidic Acid-resistant Staphylococcus aureus in Impetigo Contagiosa and Secondarily Infected Atopic Dermatitis
Department of Dermatology and Venereology, Sahlgrenska University Hospital, SE-413 45 Göteborg, Sweden.Acta Dermato-Venereologica (Impact Factor: 3.03). 01/2010; 90(1):52-7. DOI: 10.2340/00015555-0771
Fusidic acid-resistant Staphylococcus aureus (FRSA) has been identified as a causative agent in outbreaks of impetigo and its emergence has been associated with increased use of topical fusidic acid. The frequency of FRSA in atopic dermatitis (AD) has been less extensively investigated. The aim of this study was to investigate the bacterial spectrum and frequency of FRSA in patients with impetigo or secondarily infected AD. A prospective study in our clinic in 2004 to 2008 included 38 patients with impetigo and 37 with secondarily infected AD. S. aureus was the predominant finding in all groups (bullous impetigo 92% (12/13), impetigo 76% (19/25) and secondarily infected AD 89% (33/37)). Seventy-five percent of S. aureus were fusidic acid resistant in bullous impetigo, 32% in impetigo and 6.1% in secondarily infected AD (bullous impetigo vs. AD p < 0.0001, impetigo vs. AD p < 0.05). We then performed a retrospective patient record review including all patients with impetigo or secondarily infected AD seen at the clinic during the first and last year of the prospective study. In the first year 33% (19/58) of the S. aureus isolates were fusidic acid-resistant in impetigo and 12% (5/43) in secondarily infected AD (p < 0.05). In the last year corresponding values were 24% (6/25) for impetigo and 2.2% (1/45) for AD (p < 0.01). In summary, the prospective study and the patient record review both showed higher FRSA levels in impetigo than in AD. FRSA levels were persistently low in AD. Continued restrictive use of topical fusidic acid is advised to limit an increase in FRSA levels in dermatology patients.
Full-text previewDOI: · Available from: medicaljournals.se
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.
- [Show abstract] [Hide abstract]
ABSTRACT: Large scale integration is the simultaneous realization of large area circuit chips and optimum component packing density for the express purpose of reducing costs by maximizing the number of system connections done at the chip level. The highly complex monolithic circuits being offered today are obviously the forerunners of true LSI. Many questions pertinent to LSI are asked repeatedly today. Some of the more timely aspects of large scale integration are considered here. The prime objective of this paper is, therefore, to establish where LSI is today. The coverage is limited to bipolar silicon integrated circuits. A DTL design is compared to an ECL design to illustrate a basis for choice of circuit type, power level, and interrelationship with respect to resistor and transistor parameters. Arrays of DTL and ECL gates with single-layer interconnection metal are next considered; each gate is assumed to have one semiconductor crossunder tunnel. The resulting expressions relate the maximum allowable number of DTL and ECL gates in the monolayer array to circuit threshold. Next, the characteristics of metal interconnections are examined to obtain a method for predicting average interconnection length, die area occupied by the interconnections, and signal delay introduced by the interconnections. Finally, some thermal aspects of packaging a square hybrid LSI array of 2n X 2n chips are analyzed for an ECL and a DTL design. An expression is derived which relates power density of the hybrid array to the number of gates in the array and pertinent properties of the base system.IEEE Journal of Solid-State Circuits 01/1968; 2(4-2):156 - 172. DOI:10.1109/JSSC.1967.1049814 · 3.01 Impact Factor
- Skin pharmacology and physiology 09/2010; 23 Suppl(1):1-3. DOI:10.1159/000318899 · 2.37 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: Skin and soft tissue infections (SSTI) caused by Staphylococcus aureus are very common, particularly in children, in tropical regions. The proportion of S aureus SSTI caused by community-associated methicillin-resistant S aureus (CA-MRSA) varies according to region, but is up to 25% in some areas. There are diverse CA-MRSA clones, including several that harbor Panton-Valentine leukocidin. Key predisposing factors for staphylococcal infections are scabies infestation, overcrowding, poor hygiene, and inadequate water supplies. In the setting of a community outbreak of staphylococcal SSTI, interventions intended to improve personal and community hygiene are likely to be the most practical, effective, and achievable. Options for oral treatment of clinical infections caused by CA-MRSA include clindamycin and trimethoprim-sulfamethoxazole. Although rapid diagnostics are now available, and 2 vaccines have reached clinical trials, neither of these is likely to be of use in tropical, developing regions in the near future.Dermatologic clinics 01/2011; 29(1):21-32. DOI:10.1016/j.det.2010.09.005 · 1.69 Impact Factor