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JAC Advance Access published online on January 25, 2008
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkm531
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© The Author 2008. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

The EPISA study: antimicrobial susceptibility of Staphylococcus aureus causing primary or secondary skin and soft tissue infections in the community in France, the UK and Ireland

M. Denton1,*, B. O’Connell2, P. Bernard3, V. Jarlier4, Z. Williams5 and A. Santerre Henriksen5

1 Department of Microbiology, Leeds General Infirmary, Great George Street, Leeds, West Yorkshire LS1 3EX, UK 2 Department of Clinical Microbiology, Central Pathology Laboratory, St James’s Hospital, Dublin 8, Ireland 3 Hopital Robert Debré, Service Dermatologie, Avenue du Général Koening, F-51092 Reims Cedex, France 4 Service de Bactériologie-Hygiène, CHU Pitié-Salpetrière, Paris, France 5 LEO Pharma, 55 Industriparken, DK-2750 Ballerup, Denmark

Received 29 August 2007; returned 12 December 2007; revised 19 October 2007; accepted 12 December 2007

* Corresponding author. Tel: +44-113-392-2922; Fax: +44-113-343-5649; E-mail: miles.denton{at}leedsth.nhs.uk

Objectives: To provide information on the susceptibility of Staphylococcus aureus causing skin and soft tissue infections (SSTIs) in France, Ireland and the UK.

Patients and methods: One thousand three hundred and ninety patients attending their general practitioners for skin infections were recruited. Susceptibility to 11 antimicrobials using CLSI (formerly NCCLS) broth microdilution was determined for 646 S. aureus isolates detected in the evaluable patient population.

Results: Susceptibility results were similar in the UK and Ireland, but differed in France. The largest difference between countries was observed for erythromycin and fusidic acid. In France, 67.8% of isolates were susceptible to erythromycin when compared with 88.6% in Ireland and 92.8% in the UK. However, 93.7% of French isolates were susceptible to fusidic acid, compared with 68.6% in Ireland and 75.6% in the UK. A diagnosis of impetigo was associated with reduced fusidic acid susceptibility.

Conclusions: Differences in the prevalence of certain diagnoses, particularly impetigo, rather than differences in antibiotic consumption may explain some of the observed differences in susceptibility seen between these countries.

Key Words: skin infections , S. aureus , antibiotic susceptibility , SSTIs


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