Analysis of Colonization and Genotyping of the Exotoxins ofStaphylococcus aureusin Patients with Atopic Dermatitis

Abstract

BackgroundThe skin of atopic dermatitis (AD) patients has a high susceptibility to Staphylococcus aureus colonization, and the toxins produced by S. aureus may aggravate AD by acting as superantigens.ObjectiveThe purpose of this study was to evaluate the relationship of the skin barrier function, colonization of S. aureus, and the clinical severity of AD. We also examined the predominant toxin genes produced in Korean AD patients.MethodsThirty-nine patients with AD were evaluated for clinical severity and skin barrier function by using Severity Scoring of Atopic Dermatitis (SCORAD) index and transepidermal water loss (TEWL). S. aureus was isolated from the forearm, popliteal fossa, and anterior nares of AD patients (n=39) and age-matched controls (n=40); the toxin genes were analyzed by performing multiplex polymerase chain reaction.ResultsTEWL showed a statistically significant correlation with clinical severity in patients with AD (p<0.05). TEWL was correlated with the number of S. aureus colonization sites and the presence of nasal colonization, but these results were not statistically significant. S. aureus strains were isolated in 64.1% of the 39 AD patients. The SCORAD index and AD severity were strongly correlated with the number of colonization sites. The predominant toxin gene found in AD patients was staphylococcal enterotoxin a (sea) only, which was produced in 52.6% of patients. The toxin genes sea and toxic shock syndrome toxin-1 (tsst-1) were found together in 42.1%, while tsst-1 only was found in 5.3% of the patients.ConclusionS. aureus strains were isolated in 64.1% of the 39 AD patients. Skin barrier function, as measured by TEWL, revealed a statistically significant correlation with clinical severity in AD patients. The SCORAD index and severity of AD was strongly correlated with the number of colonization. The most common toxin gene was sea in the Korean AD patients and this gene might have an important role in the pathogenesis of AD.

Staphylococcus aureus colonization related to severity of hand eczema

“…We also found a significantly higher S. aureus density on the hands of patients with severe hand eczema as compared to those with mild to moderate hand eczema. Previous studies on patients with hand eczema and AD have shown a correlation between the severity of the lesions and the presence of S. aureus [6,27]. We did, however, not observe a linear correlation between extent of the eczema (HEES) and density of S. aureus.…”

The skin microbiota in pregnant women suffering from atopic dermatitis

“…В последние годы активно обсуждают роль дисбиотических изменений кожи в патогенезе АД [8,13]. Наиболее значимым микробным агентом считают S. аureus [13].…”

“…Наиболее значимым микробным агентом считают S. аureus [13]. Колонии золотистого стафилококка обнару-живают у 90% пациентов с АД (не только на воспалённых участках, но и даже в местах, которые кажутся неизменёнными), тогда как у здоровых людей лишь в 5% случаев [2,3,11,13,14].…”

“…Наши исследования под-твердили сообщения других авторов [2,3,11,13,14] о повышенной бактериальной обсеме-нённости кожи больных АД. Эти же авторы указывают на влияние S. aureus на течение АД в качестве фактора, провоцирующего и поддерживающего кожный воспалитель-ный процесс.…”

Staphylococcus Aureus Colonization and the Factors Affecting Colonization in Children with Atopic Dermatitis

“…Literatürde bugüne kadar atopik dermatitli çocuklarda yapılan çalışmaların birçoğunda SCORAD veya EASI indeksleri ile bakteriyel kolonizasyon arasında ilişki olduğu gösterilmiştir (19,26,27). Biz de önceki çalışmalar ile uyumlu olarak bakteriyel kolonizasyonun atopik dermatitin ağırlığı ile ilişkili olduğunu ve kolonizasyonun en sık ağır atopik dermatitte görüldüğünü saptadık.…”