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An unusual outbreak in the Netherlands: community-onset impetigo caused by a meticillin-resistant Staphylococcus aureus with additional resistance to fusidic acid, June 2018 to January 2020
In this retrospective observational study, we analysed a community outbreak of impetigo with meticillin-resistant Staphylococcus aureus (MRSA), with additional resistance to fusidic acid (first-line treatment). The outbreak occurred between June 2018 and January 2020 in the eastern part of the Nethe...
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| Formato: | Online Artículo Texto |
| Lenguaje: | English |
| Publicado: |
European Centre for Disease Prevention and Control (ECDC)
2022
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| Materias: | |
| Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9732922/ https://www.ncbi.nlm.nih.gov/pubmed/36695440 http://dx.doi.org/10.2807/1560-7917.ES.2022.27.49.2200245 |
| _version_ | 1784846238493966336 |
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| author | Vendrik, Karuna E.W. Kuijper, Ed J. Dimmendaal, Marieke Silvis, Welmoed Denie-Verhaegh, Els de Boer, Annemarie Postma, Bent Schoffelen, Annelot F. Ruijs, Wilhelmina L.M. Koene, Fleur M.H.P.A. Petrignani, Mariska Hooiveld, Mariëtte Witteveen, Sandra Schouls, Leo M. Notermans, Daan W. Schuurman, Robert F.W. Schipper, Bart Oijevaar, Margreeth J.C. Hiltermann, Lennard F.M. van Loenen, Geert-Jan M. Jurgens, Renate Noordenbos, Wieke I. Leeflang, Gert-Jan Janssen, Gertrude Wintermans, Bas B. Leversteijn-van Hall, Maurine A. van den Bijllaardt, Wouter van Mansfeld, Rosa van Dijk, Karin Zwart, Bas Diederen, Bram M.W. Voss, Andreas Dorigo-Zetsma, Julia W. Ott, Alewijn Oudbier, Joke H. van der Vusse, Marleen Vlek, Anneloes L.M. Buiting, Anton G.M. Bode, Lonneke Paltansing, Sunita van Griethuysen, Arjanne J. den Reijer, Martijn van Trijp, Marijke J.C.A. van Burgel, Nathalie D. Muller, Anouk E. van der Linden, Michael P.M. van Rijn, Michiel Wolfhagen, Maurice J.H.M. Waar, Karola Kolwijck, Eva Schulin, Tanja Damen, Marjolein Dinant, Sander van Mens, Suzan P. Melles, Damian C. Cohen Stuart, James W.T. Gruteke, Paul Overdevest, Ilse T.M.A. van Dam, Alje P. Maat, Ianthe Maraha, Boulos Sinnige, Jan C. Mattsson, Eva Mascini, Ellen M. Stam, Arjen de Jong, Eefje Vainio, Saara J. Heikens, Esther Steingrover, Radijn Troelstra, Annette Bathoorn, Eric Trienekens, Thera A.M. van Dam, Dick W. de Brauwer, Els I.G.B. Stals., Frans S. |
| author_facet | Vendrik, Karuna E.W. Kuijper, Ed J. Dimmendaal, Marieke Silvis, Welmoed Denie-Verhaegh, Els de Boer, Annemarie Postma, Bent Schoffelen, Annelot F. Ruijs, Wilhelmina L.M. Koene, Fleur M.H.P.A. Petrignani, Mariska Hooiveld, Mariëtte Witteveen, Sandra Schouls, Leo M. Notermans, Daan W. Schuurman, Robert F.W. Schipper, Bart Oijevaar, Margreeth J.C. Hiltermann, Lennard F.M. van Loenen, Geert-Jan M. Jurgens, Renate Noordenbos, Wieke I. Leeflang, Gert-Jan Janssen, Gertrude Wintermans, Bas B. Leversteijn-van Hall, Maurine A. van den Bijllaardt, Wouter van Mansfeld, Rosa van Dijk, Karin Zwart, Bas Diederen, Bram M.W. Voss, Andreas Dorigo-Zetsma, Julia W. Ott, Alewijn Oudbier, Joke H. van der Vusse, Marleen Vlek, Anneloes L.M. Buiting, Anton G.M. Bode, Lonneke Paltansing, Sunita van Griethuysen, Arjanne J. den Reijer, Martijn van Trijp, Marijke J.C.A. van Burgel, Nathalie D. Muller, Anouk E. van der Linden, Michael P.M. van Rijn, Michiel Wolfhagen, Maurice J.H.M. Waar, Karola Kolwijck, Eva Schulin, Tanja Damen, Marjolein Dinant, Sander van Mens, Suzan P. Melles, Damian C. Cohen Stuart, James W.T. Gruteke, Paul Overdevest, Ilse T.M.A. van Dam, Alje P. Maat, Ianthe Maraha, Boulos Sinnige, Jan C. Mattsson, Eva Mascini, Ellen M. Stam, Arjen de Jong, Eefje Vainio, Saara J. Heikens, Esther Steingrover, Radijn Troelstra, Annette Bathoorn, Eric Trienekens, Thera A.M. van Dam, Dick W. de Brauwer, Els I.G.B. Stals., Frans S. |
| author_sort | Vendrik, Karuna E.W. |
| collection | PubMed |
| description | In this retrospective observational study, we analysed a community outbreak of impetigo with meticillin-resistant Staphylococcus aureus (MRSA), with additional resistance to fusidic acid (first-line treatment). The outbreak occurred between June 2018 and January 2020 in the eastern part of the Netherlands with an epidemiological link to three cases from the north-western part. Forty nine impetigo cases and eight carrier cases were identified, including 47 children. All but one impetigo case had community-onset of symptoms. Pharmacy prescription data for topical mupirocin and fusidic acid and GP questionnaires suggested an underestimated outbreak size. The 57 outbreak isolates were identified by the Dutch MRSA surveillance as MLVA-type MT4627 and sequence type 121, previously reported only once in 2014. Next-generation sequencing revealed they contained a fusidic acid resistance gene, exfoliative toxin genes and an epidermal cell differentiation inhibitor gene. Whole-genome multilocus sequence typing revealed genetic clustering of all 19 sequenced isolates from the outbreak region and isolates from the three north-western cases. The allelic distances between these Dutch isolates and international isolates were high. This outbreak shows the appearance of community-onset MRSA strains with additional drug resistance and virulence factors in a country with a low prevalence of antimicrobial resistance. |
| format | Online Article Text |
| id | pubmed-9732922 |
| institution | National Center for Biotechnology Information |
| language | English |
| publishDate | 2022 |
| publisher | European Centre for Disease Prevention and Control (ECDC) |
| record_format | MEDLINE/PubMed |
| spelling | pubmed-97329222022-12-19 An unusual outbreak in the Netherlands: community-onset impetigo caused by a meticillin-resistant Staphylococcus aureus with additional resistance to fusidic acid, June 2018 to January 2020 Vendrik, Karuna E.W. Kuijper, Ed J. Dimmendaal, Marieke Silvis, Welmoed Denie-Verhaegh, Els de Boer, Annemarie Postma, Bent Schoffelen, Annelot F. Ruijs, Wilhelmina L.M. Koene, Fleur M.H.P.A. Petrignani, Mariska Hooiveld, Mariëtte Witteveen, Sandra Schouls, Leo M. Notermans, Daan W. Schuurman, Robert F.W. Schipper, Bart Oijevaar, Margreeth J.C. Hiltermann, Lennard F.M. van Loenen, Geert-Jan M. Jurgens, Renate Noordenbos, Wieke I. Leeflang, Gert-Jan Janssen, Gertrude Wintermans, Bas B. Leversteijn-van Hall, Maurine A. van den Bijllaardt, Wouter van Mansfeld, Rosa van Dijk, Karin Zwart, Bas Diederen, Bram M.W. Voss, Andreas Dorigo-Zetsma, Julia W. Ott, Alewijn Oudbier, Joke H. van der Vusse, Marleen Vlek, Anneloes L.M. Buiting, Anton G.M. Bode, Lonneke Paltansing, Sunita van Griethuysen, Arjanne J. den Reijer, Martijn van Trijp, Marijke J.C.A. van Burgel, Nathalie D. Muller, Anouk E. van der Linden, Michael P.M. van Rijn, Michiel Wolfhagen, Maurice J.H.M. Waar, Karola Kolwijck, Eva Schulin, Tanja Damen, Marjolein Dinant, Sander van Mens, Suzan P. Melles, Damian C. Cohen Stuart, James W.T. Gruteke, Paul Overdevest, Ilse T.M.A. van Dam, Alje P. Maat, Ianthe Maraha, Boulos Sinnige, Jan C. Mattsson, Eva Mascini, Ellen M. Stam, Arjen de Jong, Eefje Vainio, Saara J. Heikens, Esther Steingrover, Radijn Troelstra, Annette Bathoorn, Eric Trienekens, Thera A.M. van Dam, Dick W. de Brauwer, Els I.G.B. Stals., Frans S. Euro Surveill Outbreaks In this retrospective observational study, we analysed a community outbreak of impetigo with meticillin-resistant Staphylococcus aureus (MRSA), with additional resistance to fusidic acid (first-line treatment). The outbreak occurred between June 2018 and January 2020 in the eastern part of the Netherlands with an epidemiological link to three cases from the north-western part. Forty nine impetigo cases and eight carrier cases were identified, including 47 children. All but one impetigo case had community-onset of symptoms. Pharmacy prescription data for topical mupirocin and fusidic acid and GP questionnaires suggested an underestimated outbreak size. The 57 outbreak isolates were identified by the Dutch MRSA surveillance as MLVA-type MT4627 and sequence type 121, previously reported only once in 2014. Next-generation sequencing revealed they contained a fusidic acid resistance gene, exfoliative toxin genes and an epidermal cell differentiation inhibitor gene. Whole-genome multilocus sequence typing revealed genetic clustering of all 19 sequenced isolates from the outbreak region and isolates from the three north-western cases. The allelic distances between these Dutch isolates and international isolates were high. This outbreak shows the appearance of community-onset MRSA strains with additional drug resistance and virulence factors in a country with a low prevalence of antimicrobial resistance. European Centre for Disease Prevention and Control (ECDC) 2022-12-08 /pmc/articles/PMC9732922/ /pubmed/36695440 http://dx.doi.org/10.2807/1560-7917.ES.2022.27.49.2200245 Text en This article is copyright of the authors or their affiliated institutions, 2022. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution (CC BY 4.0) Licence. You may share and adapt the material, but must give appropriate credit to the source, provide a link to the licence, and indicate if changes were made. |
| spellingShingle | Outbreaks Vendrik, Karuna E.W. Kuijper, Ed J. Dimmendaal, Marieke Silvis, Welmoed Denie-Verhaegh, Els de Boer, Annemarie Postma, Bent Schoffelen, Annelot F. Ruijs, Wilhelmina L.M. Koene, Fleur M.H.P.A. Petrignani, Mariska Hooiveld, Mariëtte Witteveen, Sandra Schouls, Leo M. Notermans, Daan W. Schuurman, Robert F.W. Schipper, Bart Oijevaar, Margreeth J.C. Hiltermann, Lennard F.M. van Loenen, Geert-Jan M. Jurgens, Renate Noordenbos, Wieke I. Leeflang, Gert-Jan Janssen, Gertrude Wintermans, Bas B. Leversteijn-van Hall, Maurine A. van den Bijllaardt, Wouter van Mansfeld, Rosa van Dijk, Karin Zwart, Bas Diederen, Bram M.W. Voss, Andreas Dorigo-Zetsma, Julia W. Ott, Alewijn Oudbier, Joke H. van der Vusse, Marleen Vlek, Anneloes L.M. Buiting, Anton G.M. Bode, Lonneke Paltansing, Sunita van Griethuysen, Arjanne J. den Reijer, Martijn van Trijp, Marijke J.C.A. van Burgel, Nathalie D. Muller, Anouk E. van der Linden, Michael P.M. van Rijn, Michiel Wolfhagen, Maurice J.H.M. Waar, Karola Kolwijck, Eva Schulin, Tanja Damen, Marjolein Dinant, Sander van Mens, Suzan P. Melles, Damian C. Cohen Stuart, James W.T. Gruteke, Paul Overdevest, Ilse T.M.A. van Dam, Alje P. Maat, Ianthe Maraha, Boulos Sinnige, Jan C. Mattsson, Eva Mascini, Ellen M. Stam, Arjen de Jong, Eefje Vainio, Saara J. Heikens, Esther Steingrover, Radijn Troelstra, Annette Bathoorn, Eric Trienekens, Thera A.M. van Dam, Dick W. de Brauwer, Els I.G.B. Stals., Frans S. An unusual outbreak in the Netherlands: community-onset impetigo caused by a meticillin-resistant Staphylococcus aureus with additional resistance to fusidic acid, June 2018 to January 2020 |
| title | An unusual outbreak in the Netherlands: community-onset impetigo caused by a meticillin-resistant Staphylococcus aureus with additional resistance to fusidic acid, June 2018 to January 2020 |
| title_full | An unusual outbreak in the Netherlands: community-onset impetigo caused by a meticillin-resistant Staphylococcus aureus with additional resistance to fusidic acid, June 2018 to January 2020 |
| title_fullStr | An unusual outbreak in the Netherlands: community-onset impetigo caused by a meticillin-resistant Staphylococcus aureus with additional resistance to fusidic acid, June 2018 to January 2020 |
| title_full_unstemmed | An unusual outbreak in the Netherlands: community-onset impetigo caused by a meticillin-resistant Staphylococcus aureus with additional resistance to fusidic acid, June 2018 to January 2020 |
| title_short | An unusual outbreak in the Netherlands: community-onset impetigo caused by a meticillin-resistant Staphylococcus aureus with additional resistance to fusidic acid, June 2018 to January 2020 |
| title_sort | unusual outbreak in the netherlands: community-onset impetigo caused by a meticillin-resistant staphylococcus aureus with additional resistance to fusidic acid, june 2018 to january 2020 |
| topic | Outbreaks |
| url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9732922/ https://www.ncbi.nlm.nih.gov/pubmed/36695440 http://dx.doi.org/10.2807/1560-7917.ES.2022.27.49.2200245 |
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unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT koenefleurmhpa unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT petrignanimariska unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT hooiveldmariette unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT witteveensandra unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT schoulsleom unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT notermansdaanw unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT schuurmanrobertfw unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT schipperbart unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT oijevaarmargreethjc unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT hiltermannlennardfm unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT vanloenengeertjanm unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT jurgensrenate unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT noordenboswiekei unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT leeflanggertjan unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT janssengertrude unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT wintermansbasb unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT leversteijnvanhallmaurinea unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT vandenbijllaardtwouter unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT vanmansfeldrosa unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT vandijkkarin unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT zwartbas unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT diederenbrammw unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT vossandreas unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT dorigozetsmajuliaw unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT ottalewijn unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT oudbierjokeh unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT vandervussemarleen unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT vlekanneloeslm unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT buitingantongm unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT bodelonneke unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT paltansingsunita unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT vangriethuysenarjannej unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT denreijermartijn unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT vantrijpmarijkejca unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT vanburgelnathalied unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT mulleranouke unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT vanderlindenmichaelpm unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT vanrijnmichiel unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT wolfhagenmauricejhm unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT waarkarola unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT kolwijckeva unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT schulintanja unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT damenmarjolein unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT dinantsander unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT vanmenssuzanp unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT mellesdamianc unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT cohenstuartjameswt unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT grutekepaul unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT overdevestilsetma unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT vandamaljep unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT maatianthe unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT marahaboulos unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT sinnigejanc unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT mattssoneva unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT masciniellenm unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT stamarjen unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT dejongeefje unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT vainiosaaraj unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT heikensesther unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT steingroverradijn unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT troelstraannette unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT bathoorneric unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT trienekenstheraam unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT vandamdickw unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT debrauwerelsigb unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 AT stalsfranss unusualoutbreakinthenetherlandscommunityonsetimpetigocausedbyameticillinresistantstaphylococcusaureuswithadditionalresistancetofusidicacidjune2018tojanuary2020 |