High incidence of acquiring methicillin-resistant Staphylococcus aureus in Brazilian children with Atopic Dermatitis and associated risk factors

Abad, Eliane de Dios; Ferreira, Dennis de Carvalho; Cavalcante, Fátima Gonçalves; Saintive, Simone; Goudouris, Ekaterini; Prado, Evandro Alves do; Hofer, Cristina Barroso; Ribeiro, Márcia; Silva, Alexandre Marques Paes da; Rosado, Alexandre Soares; Elsas, Jan Dirk van; Santos, Kátia Regina Netto dos

doi:10.1016/j.jmii.2018.12.014

Cited by 13 publications

(7 citation statements)

References 31 publications

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“…However, no MRSA isolate was detected. It is important to highlight that a recent study by our group with Brazilian atopic children showed an increased chance of MRSA acquisition when the contact had colonization by the pathogen [7], a fact that confirms the intra-familial transmission. The results found in the present study, in which 66,6 % of S. aureus isolates showed similar genotypic profiles between members of a family, corroborate data from the literature and reinforce the hypothesis of cross-transmission between atopic children and their family contacts.…”

supporting

confidence: 74%

“…Molecular characterization of S. aureus isolates may be achieved by, for example, pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) [4,5]. Most of the S.aureus isolates recovered from AD children belong to well-established lineages of different geographical regions, such as USA1100/ST30, USA400/ST1 and USA800/ST5 in Brazil [6,7] and ST188 in Korea [8].…”

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confidence: 99%

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Staphylococcus aureus nasal isolates may have the same genetic profile in atopic dermatitis paediatric patients and their close contacts

Cavalcante

Alvarenga

Saintive

et al. 2020

Journal of Medical Microbiology

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Atopic dermatitis (AD) is a chronic skin disease that affects up to 20 % of the paediatric population worldwide. Staphylococcus aureus colonizes anterior nares and can be transmitted in the home environment, aggravating AD. This study aimed to detect S. aureus from nares of AD patients and their family contacts, as well as to evaluate the antimicrobial resistance, virulence and clonality of these isolates. Among the 48 family groups investigated, 30 groups were selected, as both the child and his/her respective contact had methicillin-sensitive S. aureus (MSSA) (24 cases; 54 MSSA isolates) or methicillin-resistant S. aureus (MRSA) isolates (6 cases; 13 MRSA isolates). All MRSA isolates carried SCCmec IV. S. aureus carrying PVL genes were detected in 60 % of patients. Pulsed-field gel electrophoresis (PFGE) analysis was performed for 31 isolates from 15 family groups: all 6 with MRSA and 9 with MSSA isolates. Similar genotypic profiles between isolates from patients and their family contacts were noted in 10 (66.6 %) family groups, 5 (83.3 %) of the MRSA family groups and 5 (55.5 %) of the MSSA family groups, indicating that the pathogen was transmitted through family contacts.

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confidence: 74%

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confidence: 99%

Staphylococcus aureus nasal isolates may have the same genetic profile in atopic dermatitis paediatric patients and their close contacts

Cavalcante

Alvarenga

Saintive

et al. 2020

Journal of Medical Microbiology

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“…aureus in AD patients, such as use of topical probiotics or bleach baths, should take into consideration different niches and close contacts, since they may serve as a focus for a new colonization episode or to keep the pathogen circulating in the environment. However, we emphasize that we do not advise the use of topical mupirocin in cases of colonization, even though a low prevalence of isolates with high levels of resistance was detected in this study, due to the possibility of emergence of antimicrobial resistance [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

“…aureus clonal lineages colonizing AD patients and disease severity [ 34 , 50 ], it is known that certain lineages are associated with specific characteristics, such as presence of virulence genes, biofilm formation, acquisition of resistance mechanisms, among others [ 4 , 49 , 51 , 52 ]. These findings highlight the importance of monitoring colonization by resistant isolates in this group, especially of virulent lineages, since colonization by MRSA may be associated with reduced microbial diversity of the skin [ 53 ] and presentation of more severe forms of the disease [ 37 ].…”

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confidence: 99%

Methicillin-resistant and methicillin-sensitive Staphylococcus aureus isolates from skin and nares of Brazilian children with atopic dermatitis demonstrate high level of clonal diversity

Guimarães

Assunção²,

Oliveira³

et al. 2022

PLoS ONE

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Background Atopic dermatitis (AD) primarily affects the pediatric population, which is highly colonized by S. aureus. However, little is known about the genetic features of this microorganism and other staphylococcal species that colonize AD patients. Objective This study aimed to characterize Staphylococcus spp. isolated from the nares and skin (with and without lesion) of 30 AD and 12 non-AD Brazilian children. Methods Skin and nasal swabs were cultured onto mannitol salt agar, and bacterial colonies were counted and identified by matrix assisted laser desorption ionization time of flight mass spectrometry and polymerase chain reaction (PCR). Antimicrobial susceptibility was evaluated by phenotypic and genotypic tests. In S. aureus isolates, Panton-Valentine leukocidin genes were detected by PCR, and their clonality was assessed by pulsed-field gel electrophoresis and multilocus sequence typing. Results S. aureus was more prevalent in the nares (P = 0.005) and lesional skin (P = 0.0002) of children with AD, while S. hominis was more frequent in the skin of non-AD children (P < 0.0001). All children in the study, except one from each group, were colonized by methicillin-resistant coagulase-negative Staphylococcus and 24% by methicillin-resistant S. aureus. Despite the great clonal diversity of S. aureus (18 sequence types identified), most AD children (74.1%) were colonized by the same genotype in both niches. Conclusion High colonization by polyclonal S. aureus isolates was found among children with AD, while S. hominis was more frequent among non-AD children. The high prevalence of methicillin-resistant staphylococcal isolates highlights the importance of continued surveillance, especially when considering empiric antibiotic therapy for the treatment of skin infections in these patients.

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“…Furthermore, AD is known to be linked to changes in the skin microbiome (dysbiosis) that is evidenced by the lower bacterial diversity, which is characterized by enrichment of Staphylococcus aureus and Staphylococcus epidermidis and depletion of Propionobacterium (Bjerre et al, 2017). This colonization by S. aureus demonstrates a relationship with the severity of the disease and consequently susceptibility to infections (Abad et al, 2020;Bjerre et al, 2017). The severity of AD can be classified by SCORAD or the "Scoring atopic dermatitis" index, which is based on the extension and intensity parameters of the lesions and subjective symptoms such as sleep and pruritus (Hanifin & Hajka, 1980).…”

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Clinical oral profile of pediatric patients with atopic dermatitis: A cross‐sectional study

et al. 2020

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Objectives: This work aims to describe oral health conditions, eating habits, and oral hygiene in pediatric and adolescent patients with atopic dermatitis and correlate them with the severity of the Scoring Atopic Dermatitis (SCORAD). Also, we aim to estimate the effect of several variables on the diagnosis of dental caries in these patients. Material and Methods:A total of 92 children and adolescents with atopic dermatitis had their oral cavities examined. The effect of independent variables on the diagnosis of dental caries (outcome) was assessed using multiple binary logistic regression model. Results:Mild patients presented higher score of decayed, missing, and filled teeth in permanent dentition than moderate patients (p = 0.040). In the multivariable regression final model, the covariates using inhaled corticoid (OR = 6.4; p = 0.003), type of teething [deciduous dentition (OR = 7.9; p = 0.027) and mixed dentition (OR = 10.5; p = 0.007)], and brushing quality [poor mechanical control (OR = 10.6; p < 0.0001)] demonstrated significant direct effect on the diagnosis of dental caries. Conclusions:Our findings suggest that the presence of dental biofilm, use of inhaled corticoid, and type of teething are related to the presence of caries in atopic dermatitis patients. K E Y W O R D S adolescent, atopic dermatitis, children, mouth, oral health | 1835 SODRÉ et al. | INTRODUC TI ONPediatric patients with chronic diseases generally have a higher risk for the development of oral commitment, which may be related to the pathological mechanism of the disease itself or even to the implemented therapy (Turkistani et al., 2010). Among the diseases that most affect individuals since early childhood, there are topic disorders, like dental caries and atopic dermatitis (Bagramian et al., 2009;Thomsen, 2015;Williams et al., 2008). Due to its chronic feature, atopic dermatitis (AD) has numerous factors that are complexly interrelated, such as skin barrier dysfunction, genetic predisposition, immunological and environmental abnormalities, in addition to the participation of infectious agents, and psychological, nutritional, and pharmacological factors (Akdis et al., 2006;Nutten, 2015). Furthermore, AD is known to be linked to changes in the skin microbiome (dysbiosis) that is evidenced by the lower bacterial diversity, which is characterized by enrichment of Staphylococcus aureus and Staphylococcus epidermidis and depletion of Propionobacterium (Bjerre et al., 2017). This colonization by S. aureus demonstrates a relationship with the severity of the disease and consequently susceptibility to infections (Abad et al., 2020;Bjerre et al., 2017). The severity of AD can be classified by SCORAD or the "Scoring atopic dermatitis" index, which is based on the extension and intensity parameters of the lesions and subjective symptoms such as sleep and pruritus (Hanifin & Hajka, 1980). Patients with AD, especially the severe ones, tend to develop comorbidities like atopic conditions such as asthma, allergic rhinitis, and food allergies (NIAI...

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High incidence of acquiring methicillin-resistant Staphylococcus aureus in Brazilian children with Atopic Dermatitis and associated risk factors

Cited by 13 publications

References 31 publications

Staphylococcus aureus nasal isolates may have the same genetic profile in atopic dermatitis paediatric patients and their close contacts

Staphylococcus aureus nasal isolates may have the same genetic profile in atopic dermatitis paediatric patients and their close contacts

Methicillin-resistant and methicillin-sensitive Staphylococcus aureus isolates from skin and nares of Brazilian children with atopic dermatitis demonstrate high level of clonal diversity

Clinical oral profile of pediatric patients with atopic dermatitis: A cross‐sectional study

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