{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T08:39:52Z","timestamp":1790066392251,"version":"4.0.1"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2023,6,26]],"date-time":"2023-06-26T00:00:00Z","timestamp":1687737600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Belgian National Institute of Health"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,8,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>In August 2018, a public health alert was issued in Belgium regarding clusters of impetigo cases caused by the epidemic European fusidic acid-resistant impetigo clone (EEFIC) of Staphylococcus aureus. As a result, the Belgian national reference centre (NRC) was commissioned to update the epidemiology of S. aureus causing community-onset skin and soft tissues infection (CO-SSTI) to assess the proportion of EEFIC among them.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>For 1 year, Belgian clinical laboratories were asked to send their first three S. aureus isolated from CO-SSTI each month. Isolates were tested for antimicrobial susceptibility to oxacillin, mupirocin and fusidic acid. Resistant isolates were also spa typed and tested for the presence of the genes encoding the Panton\u2013Valentine leucocidin, the toxic shock syndrome toxin and the exfoliatins A and B. MLST clonal complexes were deduced from the spa types.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among the 518 S. aureus strains analysed, 487 (94.0%) were susceptible to oxacillin. Of these, 79 (16.2%) were resistant to fusidic acid, of which 38 (48.1%) belonged to the EEFIC. EEFIC isolates were mostly isolated from young patients with impetigo and showed a seasonal late summer peak.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>These results suggest the persistence of EEFIC in Belgium. Furthermore, its prevalence may lead to reconsideration of the treatment guidelines for impetigo.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkad204","type":"journal-article","created":{"date-parts":[[2023,6,26]],"date-time":"2023-06-26T14:38:39Z","timestamp":1687790319000},"page":"2061-2065","source":"Crossref","is-referenced-by-count":14,"title":["Persistence of the <i>Staphylococcus aureus<\/i> epidemic European fusidic acid-resistant impetigo clone (EEFIC) in Belgium"],"prefix":"10.1093","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6944-5380","authenticated-orcid":false,"given":"Ariane","family":"Deplano","sequence":"first","affiliation":[{"name":"Department of Microbiology, LHUB-ULB, National Reference Centre for Staphylococcus aureus and other species, Universit\u00e9 libre de Bruxelles , route de Lennik 808, 1070 Brussels , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4544-0635","authenticated-orcid":false,"given":"Marie","family":"Hallin","sequence":"additional","affiliation":[{"name":"Department of Microbiology, LHUB-ULB, National Reference Centre for Staphylococcus aureus and other species, Universit\u00e9 libre de Bruxelles , route de Lennik 808, 1070 Brussels , Belgium"},{"name":"Centre for Environmental Health and Occupational Health, Public Health School, Universit\u00e9 libre de Bruxelles , route de Lennik 808, 1070 Brussels , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3562-2937","authenticated-orcid":false,"given":"Natalia","family":"Bustos Sierra","sequence":"additional","affiliation":[{"name":"Scientific Directorate of Epidemiology and Public Health, Sciensano , J. Wytsmanstraat 14, 1050 Brussels , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0250-2664","authenticated-orcid":false,"given":"Charlotte","family":"Michel","sequence":"additional","affiliation":[{"name":"Department of Microbiology, LHUB-ULB, National Reference Centre for Staphylococcus aureus and other species, Universit\u00e9 libre de Bruxelles , route de Lennik 808, 1070 Brussels , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benoit","family":"Prevost","sequence":"additional","affiliation":[{"name":"Department of Microbiology, LHUB-ULB, National Reference Centre for Staphylococcus aureus and other species, Universit\u00e9 libre de Bruxelles , route de Lennik 808, 1070 Brussels , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9307-7418","authenticated-orcid":false,"given":"Delphine","family":"Martiny","sequence":"additional","affiliation":[{"name":"Department of Microbiology, LHUB-ULB, National Reference Centre for Staphylococcus aureus and other species, Universit\u00e9 libre de Bruxelles , route de Lennik 808, 1070 Brussels , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1706-6869","authenticated-orcid":false,"given":"Nicolas","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Microbiology, LHUB-ULB, National Reference Centre for Staphylococcus aureus and other species, Universit\u00e9 libre de Bruxelles , route de Lennik 808, 1070 Brussels , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,6,26]]},"reference":[{"key":"2023080202252832900_dkad204-B1","doi-asserted-by":"crossref","first-page":"1505","DOI":"10.1128\/JCM.01984-06","article-title":"Characterization of the epidemic European fusidic acid-resistant impetigo clone of Staphylococcus aureus","volume":"45","author":"O\u2019Neill","year":"2007","journal-title":"J Clin Microbiol"},{"key":"2023080202252832900_dkad204-B2","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1093\/jac\/dkn456","article-title":"Presence of the epidemic European fusidic acid-resistant impetigo clone (EEFIC) of Staphylococcus aureus in France","volume":"63","author":"Laurent","year":"2008","journal-title":"J Antimicrob Chemother"},{"key":"2023080202252832900_dkad204-B3","doi-asserted-by":"crossref","first-page":"1176","DOI":"10.1093\/jac\/dkr590","article-title":"Spread of the epidemic European fusidic acid-resistant impetigo clone (EEFIC) in general practice patients in the south of The Netherlands","volume":"67","author":"Rijnders","year":"2012","journal-title":"J Antimicrob Chemother"},{"key":"2023080202252832900_dkad204-B4","doi-asserted-by":"crossref","first-page":"832","DOI":"10.3109\/00365548.2014.947317","article-title":"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","volume":"46","author":"R\u00f8rtveit","year":"2014","journal-title":"Scand J Infect Dis"},{"key":"2023080202252832900_dkad204-B5","author":"BAPCOC","year":"2022"},{"key":"2023080202252832900_dkad204-B6","author":"Bons","year":"2019"},{"key":"2023080202252832900_dkad204-B7","doi-asserted-by":"crossref","first-page":"1514","DOI":"10.1128\/JCM.40.4.1514-1517.2002","article-title":"Evaluation of a Triplex PCR assay to discriminate Staphylococcus aureus from coagulase-negative staphylococci and determine methicillin resistance from blood cultures","volume":"40","author":"Maes","year":"2002","journal-title":"J Clin Microbiol"},{"key":"2023080202252832900_dkad204-B8","doi-asserted-by":"crossref","first-page":"2820","DOI":"10.1128\/AAC.40.12.2820","article-title":"Identification of chromosomal location of mupA gene, encoding low-level mupirocin resistance in staphylococcal isolates","volume":"40","author":"Ramsey","year":"1996","journal-title":"Antimicrob Agents Chemother"},{"key":"2023080202252832900_dkad204-B9","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1128\/IAI.70.2.631-641.2002","article-title":"Relationships between Staphylococcus aureus genetic background, virulence factors, agr groups (alleles), and human disease","volume":"70","author":"Jarraud","year":"2002","journal-title":"Infect Immun"},{"key":"2023080202252832900_dkad204-B10","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1007\/978-1-60327-999-4_15","article-title":"Spa typing for epidemiological surveillance of Staphylococcus aureus","volume":"551","author":"Hallin","year":"2009","journal-title":"Methods Mol Biol"},{"key":"2023080202252832900_dkad204-B11","doi-asserted-by":"crossref","first-page":"5442","DOI":"10.1128\/JCM.41.12.5442-5448.2003","article-title":"Typing of methicillin-resistant Staphylococcus aureus in a university hospital setting by using novel software for spa repeat determination and database management","volume":"41","author":"Harmsen","year":"2003","journal-title":"J Clin Microbiol"},{"key":"2023080202252832900_dkad204-B12","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1128\/JCM.01866-06","article-title":"Validation of pulsed-field gel electrophoresis and spa typing for long-term, nationwide epidemiological surveillance studies of Staphylococcus aureus infections","volume":"45","author":"Hallin","year":"2007","journal-title":"J Clin Microbiol"},{"key":"2023080202252832900_dkad204-B13","doi-asserted-by":"crossref","first-page":"978","DOI":"10.3201\/eid0908.030089","article-title":"Community-acquired methicillin-resistant Staphylococcus aureus carrying Panton-Valentine leukocidin genes: worldwide emergence","volume":"9","author":"Vandenesch","year":"2003","journal-title":"Emerg Infect Dis"},{"key":"2023080202252832900_dkad204-B14","article-title":"Interventions for impetigo","volume":"1","author":"Koning","year":"2012","journal-title":"Cochrane Database Syst Rev"},{"key":"2023080202252832900_dkad204-B15","author":"Haute autorit\u00e9 de sant\u00e9","year":"2019"},{"key":"2023080202252832900_dkad204-B16","author":"National Institute for Health and Care Excellence","year":"2020"},{"key":"2023080202252832900_dkad204-B17","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1111\/j.1365-2230.2005.01847.x","article-title":"Seasonal occurrence of impetigo: a retrospective 8-year review (1996\u20132003)","volume":"30","author":"Loffeld","year":"2005","journal-title":"Clin Exp Dermatol"},{"key":"2023080202252832900_dkad204-B18","doi-asserted-by":"crossref","DOI":"10.2807\/1560-7917.ES.2022.27.49.2200245","article-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","volume":"27","author":"Vendrik","year":"2022","journal-title":"Euro Surveill"},{"key":"2023080202252832900_dkad204-B19","doi-asserted-by":"crossref","first-page":"855","DOI":"10.2165\/00003495-200868060-00008","article-title":"Retapamulin: a review of its use in the management of impetigo and other uncomplicated superficial skin infections","volume":"68","author":"Yang","year":"2008","journal-title":"Drugs"},{"key":"2023080202252832900_dkad204-B20","doi-asserted-by":"crossref","first-page":"197","DOI":"10.3390\/tropicalmed6040197","article-title":"Feasibility study for a randomised controlled trial for the topical treatment of impetigo in Australian general practice","volume":"6","author":"Gorges","year":"2021","journal-title":"Trop Med Infect Dis"}],"container-title":["Journal of Antimicrobial Chemotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jac\/article-pdf\/78\/8\/2061\/50967365\/dkad204.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jac\/article-pdf\/78\/8\/2061\/50967365\/dkad204.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,2]],"date-time":"2023-08-02T02:26:24Z","timestamp":1690943184000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jac\/article\/78\/8\/2061\/7207651"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,26]]},"references-count":20,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2023,6,26]]},"published-print":{"date-parts":[[2023,8,2]]}},"URL":"https:\/\/doi.org\/10.1093\/jac\/dkad204","relation":{},"ISSN":["0305-7453","1460-2091"],"issn-type":[{"value":"0305-7453","type":"print"},{"value":"1460-2091","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,8]]},"published":{"date-parts":[[2023,6,26]]}}}