Epidemiological Characteristics of Methicillin-Resistant Staphylococcus aureus Isolates from Children with Eczematous Atopic Dermatitis Lesions

Abstract

In this study, we investigated the rate of colonization of skin of children with atopic dermatitis (AD) by methicillin-resistant Staphylococcus aureus (MRSA) and characterized the isolates. Active skin lesions in pediatric AD patients were cultured with Rodac Staph (Komed, Korea). S. aureus isolates were examined for drug susceptibilities, analyzed for the eta, etb, tst, and pvl genes, and typed using agr polymorphism, pulsed-field gel electrophoresis of SmaI-restricted chromosomal DNA, and staphylococcal cassette chromosome mec (SCCmec) typing. Eighty-seven (75.4%) of 115 patients had cultivable S. aureus isolates, 16 of which (18.3%) were MRSA. All MRSA isolates were susceptible to chloramphenicol, rifampin, cotrimoxazole, and ciprofloxacin. While methicillin-susceptible S. aureus (MSSA) isolates were composed of 23 isolates of singular types and nine clusters comprising 48 isolates, MRSA isolates were typed into three clones: eight isolates of pulsotype A-agr-1-SCCmec IV, five isolates of pulsotype B-agr-3-SCCmec IIb-etb positive, and three isolates of pulsotype C-agr-3-SCCmec IV. Three SCCmec IVA MRSA isolates were tst positive, but none were positive for the pvl or eta gene. Among 71 MSSA isolates, 7 isolates were tst positive, 6 of which were pulsotype F-agr-3, and 9 of 10 agr-4 isolates were eta positive. The average ages of patients carrying MSSA, SCCmec IVA MRSA, and SCCmec IIb MRSA were 7.7 ؎ 4.6, 3.1 ؎ 1.5, and 8.2 ؎ 3.1 years, respectively. Among the patients carrying MRSA, two patients had been treated with oral antimicrobials, and one had been admitted to the hospital 18 months previously. In conclusion, community-acquired MRSA isolates of a few clones colonized the skin of patients with AD without risk factors for the acquisition of hospital-acquired MRSA, which suggested that the skin of children with AD may represent a significant reservoir of MRSA colonization in the community.

Cutaneous <i>Malassezia</i> Microbiota in Atopic Dermatitis Patients Differ by Gender and Body Part

“…A previous report suggested that the detection rate of MRSA from the skin of AD patients was 43.8% in AD inpatients and 29.4% in AD outpatients [34]. Moreover, there has been a report as well that the detection rate of MRSA from pediatric AD outpatients was 18.3% [35]. In this study of AD outpatients, the rate of detection of MRSA was 2.3% (6/261).…”

Methicillin-Resistant Staphylococcus aureus pada Penderita Dermatitis Atopik dan Sensitivitasnya terhadap Mupirosin Dibandingkan dengan Gentamisin

“…4 Kolonisasi MRSA pada individu yang sehat dilaporkan sebanyak 5,1% di Korea Selatan, 4,3% di Jepang, dan 1,9% di Taiwan. 5 Galur MRSA saat ini tidak hanya resisten terhadap metisilin, melainkan memiliki sifat multiresisten terhadap berbagai antibiotik lain yang umum digunakan seperti aminoglikosida, makrolid, kloramfenikol, dan fluorokuinolon, namun istilah MRSA masih digunakan. 4 Seiring ditemukan CA-MRSA di masyarakat, dapat ditemukan pada lesi kulit penderita DA, 5 terutama penderita DA dengan derajat sedang sampai berat.…”

“…Chung dkk. 5 melaporkan MRSA sebanyak 18,4%. Pengobatan lini pertama DA dengan emolien dan kortikosteroid topikal.…”

“…4 Kolonisasi bakteri S. aureus pada penderita DA dapat menyebabkan penderita menjadi rentan untuk eksaserbasi, sedangkan kolonisasi MRSA akan menyebabkan penderita mempunyai faktor predisposisi infeksi kulit yang berat. 5 Pengobatan lini pertama DA yaitu penggunaan emolien dan kortikosteroid topikal. 3 Terapi tambahan berupa antibiotik topikal dianjurkan untuk penderita DA derajat sedang sampai berat untuk mengurangi jumlah kolonisasi dan menekan produksi toksin atau superantigen yang dihasilkan oleh bakteri tersebut.…”

Infecções por Staphylococcus aureus: mudança do perfil epidemiológico no Hospital Universitário Pedro Ernesto

“…O 16 No Brasil, Moreira e colaboradores avaliaram pacientes com infecção pelo MRSA em um hospital universitário e também encontraram maior número de casos de sepse e mortalidade entre pacientes com bacteremia por MRSA.…”