An epidemic of bullous impetigo in the municipality of Austevoll in the year 2002

Background: Rising numbers of bullous impetigo caused by Staphylococcus aureus resistant to fucidic acid have been seen in Norway over the last few years.

Methods: We present a population-based cohort study of an epidemic in an island community in western Norway with approximately 4450 people. The district's doctors agreed upon guidelines for regimes of antibiotic treatment; taking specimens for bacteriological examination was made routine procedure. The patients included in the study were identified from all patient files from all consultations with all doctors in the district. Clinical, therapeutical and bacteriological variables were registered. A comparison with the present Norwegian guidelines developed by a conference of experts is made.

Results: 108 patients were diagnosed as having bullous impetigo (2.4% of the population). Bacteriological swabs were taken from 95 (88%) patients. Staphylococcus aureuswas the bacteriologic aetiology in 79 (83%) of these and were found to be resistant to fusidic acid in 67 (85%) isolates.

Conclusions: Our findings support the hypothesis that the rising numbers of impetigo might be caused by a clone of Staphylococcus aureus that is resistant to fusidic acid.