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Verfasst von:Nurjadi, Dennis [VerfasserIn]   i
 Zanger, Philipp [VerfasserIn]   i
Titel:Skin and soft tissue infections in intercontinental travellers and the import of multi-resistant Staphylococcus aureus to Europe
Verf.angabe:D. Nurjadi, B. Friedrich-Jänicke, J. Schäfer, P.J.J. Van Genderen, A. Goorhuis, A. Perignon, A. Neumayr, A. Mueller, A. Kantele, M. Schunk, J. Gascon, A. Stich, C. Hatz, E. Caumes, M. P. Grobusch, R. Fleck, F.P. Mockenhaupt and P. Zanger
E-Jahr:2015
Jahr:28 January 2015
Umfang:10 S.
Fussnoten:Gesehen am 17.06.2020
Titel Quelle:Enthalten in: Clinical microbiology and infection
Ort Quelle:Oxford : Elsevier, 1995
Jahr Quelle:2015
Band/Heft Quelle:21(2015), 6, Seite 567.e1-567.e10
ISSN Quelle:1469-0691
Abstract:Staphylococcus aureus is emerging globally. Treatment of infections is complicated by increasing antibiotic resistance. We collected clinical data and swabs of returnees with skin and soft tissue infections (SSTI) at 13 travel-clinics in Europe (www.staphtrav.eu). Sixty-two percent (196/318) SSTI patients had S. aureus-positive lesions, of which almost two-thirds (122/196) were Panton-Valentine leukocidin (PVL) positive. PVL was associated with disease severity, including hospitalization for SSTI (OR 5.2, 95% CI 1.5-18.2). In returnees with SSTI, longer travel and more intense population contact were risk factors for nasal colonization with PVL-positive S. aureus. Imported S. aureus frequently proved resistant to trimethoprim-sulfamethoxazole (21%), erythromycin (21%), tetracycline (20%), ciprofloxacin (13%), methicillin (12%) and clindamycin (8%). Place of exposure was significantly (p < 0.05) associated with predominant resistance phenotypes and spa genotypes: Latin America (methicillin; t008/CC24/304), Africa (tetracycline, trimethoprim-sulfamethoxazole; t084/CC84, t314/singleton, t355/CC355), South Asia (trimethoprim-sulfamethoxazole, ciprofloxacin; t021/CC21/318), South-East Asia (clindamycin; t159/CC272). USA300-like isolates accounted for 30% of all methicillin-resistant S. aureus imported to Europe and were predominantly (71%) acquired in Latin America. Multi-resistance to non-β-lactams were present in 24% of imports and associated with travel to South Asia (ORcrude 5.3, 95% CI 2.4-11.8), even after adjusting for confounding by genotype (ORadjusted 3.8, 95% 1.5-9.5). Choosing randomly from compounds recommended for the empiric treatment of severe S. aureus SSTI, 15% of cases would have received ineffective antimicrobial therapy. These findings call for the development of regionally stratified guidance on the antibiotic management of severe imported S. aureus disease and put the infected and colonized traveller at the centre of interventions against the global spread of multi-resistant S. aureus.
DOI:doi:10.1016/j.cmi.2015.01.016
URL:Bitte beachten Sie: Dies ist ein Bibliographieeintrag. Ein Volltextzugriff für Mitglieder der Universität besteht hier nur, falls für die entsprechende Zeitschrift/den entsprechenden Sammelband ein Abonnement besteht oder es sich um einen OpenAccess-Titel handelt.

Volltext: https://doi.org/10.1016/j.cmi.2015.01.016
 Volltext: http://www.sciencedirect.com/science/article/pii/S1198743X15002219
 DOI: https://doi.org/10.1016/j.cmi.2015.01.016
Datenträger:Online-Ressource
Sprache:eng
Sach-SW:Drug resistance
 emerging communicable diseases
 methicillin-resistant
 molecular epidemiology
 Panton-Valentine leukocidin
 risk factors
 sentinel surveillance
 staphylococcal skin infections
 travel medicine
 trimethoprim-sulfamethoxazole combination
K10plus-PPN:1700764055
Verknüpfungen:→ Zeitschrift

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