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. 2007 May;45(5):1505-10.
doi: 10.1128/JCM.01984-06. Epub 2007 Mar 7.

Characterization of the epidemic European fusidic acid-resistant impetigo clone of Staphylococcus aureus

A J O'Neill  1 , A R Larsen, R Skov, A S Henriksen, I Chopra
Affiliations

Characterization of the epidemic European fusidic acid-resistant impetigo clone of Staphylococcus aureus

A J O'Neill et al. J Clin Microbiol. 2007 May.

Abstract

Resistance to the antibiotic fusidic acid in European strains of Staphylococcus aureus causing impetigo has increased in recent years. This increase appears to have resulted from clonal expansion of a strain we have designated the epidemic European fusidic acid-resistant impetigo clone (EEFIC), which carries the fusidic acid resistance determinant fusB on its chromosome. To understand better the properties of the EEFIC responsible for its success, we have performed detailed phenotypic and genotypic characterization of this clone. Molecular typing revealed the EEFIC to be ST123, spa type t171, and agr type IV and therefore unrelated to earlier prevalent fusB(+) strains found in the United Kingdom. EEFIC strains exhibited resistance to fusidic acid, penicillin, and, in some cases, erythromycin, which are all used in the treatment of impetigo. PCR analysis of the EEFIC and complete DNA sequencing of the 39.3 Kb plasmid it harbors identified genes encoding several toxins previously implicated in impetigo (exfoliative toxins A and B and EDIN-C). The location of fusB was mapped on the chromosome and found to be associated with a novel 16.6-kb genomic island integrated downstream of groEL. Although this element is related to classical staphylococcal pathogenicity islands, it does not encode any known virulence factors and consequently has been designated SaRI(fusB) (for "S. aureus resistance island carrying fusB").

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Figures

FIG. 1.
FIG. 1.
Genetic architecture of the pETB plasmid and the closely related plasmid (pETB2) found in the EEFIC. ORFs are indicated as gray arrows, and genes of interest are indicated as black arrows. The top of the figure shows the 1,082-bp portion carrying a disrupted rep gene that is present in pETB2 but not in pETB.
FIG. 2.
FIG. 2.
Genetic architecture and chromosomal context of SaRIfusB. The predicted termini of SaRIfusB are indicated by the vertical arrows. Chromosomal genes up- and downstream of SaRIfusB are indicated in white, genes apparently acquired from plasmid pUB101 are indicated in black, and other predicted genes are indicated in gray. The genes and the products they encode are described in the table below the diagram.
FIG. 2.
FIG. 2.
Genetic architecture and chromosomal context of SaRIfusB. The predicted termini of SaRIfusB are indicated by the vertical arrows. Chromosomal genes up- and downstream of SaRIfusB are indicated in white, genes apparently acquired from plasmid pUB101 are indicated in black, and other predicted genes are indicated in gray. The genes and the products they encode are described in the table below the diagram.
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