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Increasing trend in fusidic acid resistance among MRSA isolates in the Netherlands, 2016–23

Title: Increasing trend in fusidic acid resistance among MRSA isolates in the Netherlands, 2016–23
Authors: Velthuis, F; Nauta, I M; Altorf-van der Kuil, W; Notermans, D W; Zwittink, R D; Schoffelen, A F; de Greeff, S C; Cohen Stuart, J W T; Melles, D C; van Dijk, K; Schade, R; Alzubaidy, A; Scholing, M; Kuil, S D; Blaauw, G J; Bierman, S M; Groenendijk, S R; Hertroys, R; Kruithof, L; Polman, J; van den Reek, W J; Wielders, C C H; de Wit, B J; Zoetigheid, R E; van den Bijllaardt, W; Kraan, E M; Haeseker, M B; da Silva, J M; de Jong, E; Maraha, B; van Meer, M P A; Wintermans, B B; Hira, V; Muller, A E; Wong, M; Huizinga, P; Bathoorn, E; Lokate, M; Sinnige, J; Bank, L E A; Sebens, F W; Kolwijck, E; Reuland, E A; Dorigo-Zetsma, J W
Contributors: Dutch Ministry of Health, Welfare and Sport
Source: JAC-Antimicrobial Resistance ; volume 7, issue 6 ; ISSN 2632-1823
Publisher Information: Oxford University Press (OUP)
Publication Year: 2025
Description: Objectives Recently, several MRSA community outbreaks occurred in the Netherlands, including one caused by an impetigo-causing MRSA strain resistant to fusidic acid. Since fusidic acid and flucloxacillin are the main treatment options for impetigo, increasing resistance limits treatment possibilities. We examined trends in fusidic acid resistance percentages among MRSA isolates in the Netherlands. Materials and methods Data on routine bacteriological cultures between 2016 and 2023 from 30 laboratories were extracted from the national surveillance system on antimicrobial resistance (ISIS–AR). Fusidic acid resistance percentages per year were calculated both overall and per age group for all MRSA isolates, and more specific, for the subset of MRSA isolates from wound/pus/skin samples collected by general practitioners (WPS-GP). Trends were determined using logistic regression and compared with trends among MSSA isolates. Results We found an increase in fusidic acid resistance among MRSA isolates from 15% (2016) to 29% (2023) (P < 0.001), which differed significantly (P < 0.001) from the trend among MSSA isolates (10%–12%). An increase was also found in MRSA WPS-GP isolates, both among young children and the population of 13–64 years old, but not among elderly. The trends remained significant after exclusion of isolates associated with known fusidic acid-resistant MRSA outbreaks, both among MRSA isolates overall (OR = 1.10, 95% CI: 1.07–1.14, P < 0.001) and among MRSA WPS-GP isolates (OR = 1.14, 1.07–1.21, P < 0.001). Conclusions In conclusion, an increasing trend in fusidic acid resistance was found among MRSA isolates. Since impaired treatment for impetigo might ease the spread of (fusidic acid-resistant) MRSA, extra vigilance is warranted.
Document Type: article in journal/newspaper
Language: English
DOI: 10.1093/jacamr/dlaf229
Availability: https://doi.org/10.1093/jacamr/dlaf229; https://academic.oup.com/jacamr/article-pdf/7/6/dlaf229/65766329/dlaf229.pdf
Rights: https://creativecommons.org/licenses/by-nc/4.0/
Accession Number: edsbas.F2487742
Database: BASE