Related Experiment Videos
Clinical relevance of resistance to fusidic acid in Staphylococcus aureus
1Department of Microbiology, Charing Cross and Westminster Medical School, London, UK.
Abstract:
The clinical relevance of resistance to fusidic acid in Staphylococcus aureus is reviewed. Resistance due to a one-step chromosomal mutation emerges readily in vitro. These variants appear defective and are not encountered clinically as frequently as would be expected. The majority of strains isolated from patients probably have plasmid-mediated resistance. The plasmid may be unstable both in vitro and in vivo. There appears to be a low incidence of resistance emerging when fusidic acid is used alone to treat acute infections; however, there is a higher incidence in chronic infections. When fusidic acid is given concurrently with another antibacterial agent to treat severe infection, resistance may be acquired in up to 1% of cases. The use of fusidic acid topically to treat acute skin infection in domiciliary practice does not appear to be epidemiologically hazardous. Over the last 20 years, during which fusidic acid has been used widely in the management of staphylococcal infection, the general level of resistance has remained low at 1-2%.
Insights
Fusidic acid resistance in Staphylococcus aureus is reviewed. While chromosomal mutations emerge readily in vitro, plasmid-mediated resistance is more common clinically, with overall resistance remaining low at 1-2% over 20 years.
Area of Science:
- Microbiology
- Clinical Pharmacology
- Infectious Diseases
Background:
- Fusidic acid is a crucial antibiotic for treating Staphylococcus aureus infections.
- Understanding resistance mechanisms is vital for effective treatment strategies.
- The clinical impact of fusidic acid resistance requires ongoing evaluation.
Purpose of the Study:
- To review the clinical relevance of fusidic acid resistance in Staphylococcus aureus.
- To analyze the mechanisms and prevalence of resistance.
- To assess the impact of different treatment scenarios on resistance emergence.
Main Methods:
- Literature review of studies on fusidic acid resistance in Staphylococcus aureus.
- Analysis of in vitro and clinical data on resistance mechanisms (chromosomal vs. plasmid-mediated).
- Evaluation of resistance incidence in various clinical settings and treatment regimens.
Main Results:
- Chromosomal resistance mutations emerge readily in vitro but are less common clinically.
- Plasmid-mediated resistance is more prevalent, though plasmids can be unstable.
- Low incidence of resistance with topical or combined therapy; higher in chronic infections.
- Overall fusidic acid resistance in Staphylococcus aureus has remained low (1-2%) over two decades.
Conclusions:
- Fusidic acid remains a valuable therapeutic option due to generally low resistance rates.
- Plasmid-mediated resistance is the primary clinical concern, necessitating careful monitoring.
- Topical use and combination therapy appear to minimize resistance development.