Bacterial pattern and antibiotic sensitivity in children and adolescents with infected atopic dermatitis

Samosir, Carolus Trianda; Ruslie, Riska Habriel; Rusli, Rita Evalina

doi:10.1088/1755-1315/125/1/012054

Cited by 2 publications

(7 citation statements)

References 14 publications

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“…This is especially important in patients with AD as skin infections are more common in those with severe AD. 13 In keeping with our findings, infections rarely occur on the face or abdomen, 9 but it is not clear why the lower limbs had more infections in our study. Increased exposure of the limbs to the external environment may explain this finding.…”

Section: Discussionsupporting

confidence: 53%

“…Unlike other studies, no enterococci or other bacteria were cultured in our study. 13 Staphylococcus aureus was mostly sensitive to amoxicillin-clavulanic acid and cloxacillin whereas GAS was mostly sensitive to ampicillin.…”

Section: Discussionmentioning

confidence: 99%

“…As has been documented in other studies, staphylococcal infection was the predominant cutaneous bacterial infection in our setting. 7,8,13 However, concomitant GAS infection should always be borne in mind as previous studies indicate rates as high as 62.0%. 7,8 The latter validates the empiric use of amoxicillin-clavulanic acid and flucloxacillin in the treatment of infected AD patients as both these medicines are almost always effective for both infections.…”

Section: Discussionmentioning

confidence: 99%

“…In other settings, MRSA has been noted in a range from 6.4% to 30.5%. 13 In some of these settings, erythromycin, clindamycin and cephalosporins have been recommended for the treatment of MRSA. 14,15 However, in our setting, clindamycin and erythromycin are not effective options, 13 given the 67.6% and 83.4% resistance levels, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…13 In some of these settings, erythromycin, clindamycin and cephalosporins have been recommended for the treatment of MRSA. 14,15 However, in our setting, clindamycin and erythromycin are not effective options, 13 given the 67.6% and 83.4% resistance levels, respectively. Consultation with infectious diseases and medical microbiology specialists will be needed in MRSA cases.…”

Section: Discussionmentioning

confidence: 99%

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Microbiologic characterisation of bacterial infections in children with atopic dermatitis

Zwane

Masuka

Chateau

et al. 2022

Southern African Journal of Infectious Diseases

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Background: Patients with atopic dermatitis (AD), the commonest chronic inflammatory skin disease are often colonised and infected by Staphylococcus aureus. In this study, we aimed to determine the type and antibacterial sensitivities of the bacteria infecting eczematous lesions in children with AD and to recommend first-line antibiotic therapy.Methods: A prospective study was conducted from June 2020 to June 2021 in children with AD presenting with a cutaneous infection at the King Edward hospital VIII outpatient dermatology clinic. Swabs were collected for microbial culture, confirming infections and assessing antibiotic sensitivity for infected sites.Results: Ninety six children were recruited during the study period with a mean age of 4.3 ± 3.4 years. The commonest cause of bacterial infection was Staphylococcus aureus seen in 74 (77.1%) cases, followed by Staphylococcus aureus and Group A β-haemolytic streptococcus (GAS) co-infection in 22 (22.9%) cases. The majority of these infections were observed on the lower limbs in 50 (52.08%) cases and in moderate 37 (38.5%) cases and severe eczema cases of 38 (39.6%) in AD. There was no gender predilection. Staphylococcus aureus was sensitive to amoxicillin-clavulanic acid in 57 (77.0%) cases, cloxacillin in 53 (71.6%) cases and clindamycin in 24 (32.4%) cases, whereas GAS was mostly sensitive to ampicillin in 10 (45.5%) cases. No swabs retained a resistant strain.Conclusion: Staphylococcus aureus is the commonest bacterial cause of cutaneous infection in children with AD in our setting. Amoxicillin-clavulanic acid and cloxacillin remain the most sensitive therapeutic options for this infection, however, a larger study is required to explore resistance strains, if any, in our setting.

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Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Microbiologic characterisation of bacterial infections in children with atopic dermatitis

Zwane

Masuka

Chateau

et al. 2022

Southern African Journal of Infectious Diseases

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Global Antimicrobial Susceptibility Patterns of Staphylococcus aureus in Atopic Dermatitis

Elizalde-Jiménez,

Ruiz-Hernández,

Carmona-Cruz

et al. 2024

JAMA Dermatol

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ImportanceIndividuals with atopic dermatitis are frequently colonized and infected with Staphylococcus aureus. Empirical antibiotic therapy for individuals with atopic dermatitis is common, but data about the antimicrobial susceptibility profiles of S aureus strains isolated from these individuals are scarce for those living in particular geographic areas.ObjectiveTo determine the antimicrobial susceptibility of S aureus from individuals with atopic dermatitis and analyze differences according to the income level of the country of origin and the data collection period.Data SourcesA meta-analysis of the literature was performed from the inception of the included databases (MEDLINE, Embase, Web of Science, Scopus, and Cochrane) to June 20, 2023, using predetermined Medical Subject Headings.Study SelectionStudies were included if they reported antibiotic susceptibility profiles of 1 or more S aureus cutaneous isolates from individuals with atopic dermatitis. Articles written in English, Spanish, French, or German were included.Data Extraction and SynthesisWorking in pairs, 6 of the authors conducted the data extraction. The guidelines from the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) were followed.Main Outcomes and MeasuresThe outcome of interest was antimicrobial susceptibility.ResultsA total of 61 studies reported 4091 S aureus isolates from individuals with atopic dermatitis. For 4 of the 11 commonly used antibiotics (36.4%), antimicrobial susceptibility was 85% or less, including for methicillin (binomial proportion, 0.85 [95% CI, 0.76-0.91]), erythromycin (binomial proportion, 0.73 [95% CI, 0.61-0.83]), fusidic acid (binomial proportion, 0.80 [95% CI, 0.62-0.91]), and clindamycin (binomial proportion, 0.79 [95% CI, 0.65-0.89]). Most studies (46; 75.4%) were conducted in high-income countries. Antimicrobial susceptibility to erythromycin, methicillin, and trimethoprim and sulfamethoxazole was significantly lower in lower middle–income countries and upper middle–income countries. Regarding the temporal trends, 33 studies (54.1%) reported data collected from 1998 to 2010. Antimicrobial susceptibility patterns have not changed over time.Conclusions and RelevanceIn this systematic review and meta-analysis, antimicrobial susceptibility of S aureus to β-lactams, erythromycin, clindamycin, and fusidic acid may be suboptimal for empirical use in individuals with atopic dermatitis. Significant differences in antimicrobial susceptibility patterns were found in high-income countries and in lower middle–income countries and upper middle–income countries for some antibiotics.

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Bacterial pattern and antibiotic sensitivity in children and adolescents with infected atopic dermatitis

Cited by 2 publications

References 14 publications

Microbiologic characterisation of bacterial infections in children with atopic dermatitis

Microbiologic characterisation of bacterial infections in children with atopic dermatitis

Global Antimicrobial Susceptibility Patterns of Staphylococcus aureus in Atopic Dermatitis

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