IMPETIGO IN FRENCH-GUYANA - A PROSPECTIVE CLINICAL, BACTERIOLOGICAL, TOXICOLOGICAL AND ANTIBIOTICS SUSCEPTIBILITY STUDY

Objective. We evaluated pertinent features of impetigo in French Guyan a due to the increasing number of therapeutic failures with macrolides and fusidic acid. Patients and methods. A prospective study study was conducted over a 14-month period in the dermatology unit of the Cayen ne hospital. Two groups of patients were identified: group 1 included patients with impetigo and group 2 patients with infected skin reactio ns. Epidemiological, bacteriological, toxinological (exofoliatines, le ukocidine) and antibiotic data were recorded. Results. Forty-one patie nts with impetigo and 31 patients with infected skin reactions were in cluded. Staphylococcus infection alone was identified in most patients (68 p.100) in the impetigo group. Exfoliatine-producing strains were strongly associated with Staphylococcus-induced bullous and non-bullou s impetigo (93 p. 100) compared with other origins (impetigo with stre ptococcal infection or infected skin reactions). Resistance to macroli des was high (erythromycin 41 p. 100, fusidic acid 42 p. 100) for all isolated strains of Staphylococcus aureus. Conclusion. A sub-group of patients with impetigo was identified. These patients had pure staphyl ococcal infections characterized by strong association with exfoliatin e production. The rate of resistance to macrolides was particularly hi gh in this sub-group. Resistance to fusidic acid was high for all Stap hylococcus strains isolated.