Mupirocin and the eradication of Staphylococcus aureus in atopic dermatitis

Luber, H.

doi:10.1001/archderm.124.6.853

Cited by 6 publications

(2 citation statements)

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“…by the release of T,,2-like cytokine pattern. In several studies a reduction in the bacterial load by antibiotic therapy was noted to be associ ated with clinical improvement [31]. We demonstrate that, compared to normal controls, in vitro stimulation of PBMCs and purified T-ccIl populations from atopic donors with staphylococcal superantigens results in the production of a cytokine profile consistent with a predominant TM 2-rc-sponder population.…”

Section: Discussionmentioning

confidence: 56%

Responsiveness of Peripheral Blood Mononuclear Cells from Normal and Atopic Donors to Microbial Superantigens

König¹,

Neuber²,

König³

1995

Int Arch Allergy Immunol

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Patients with atopic dermatitis (AD) are frequently colonized with Staphylococcus aureus strains secreting exotoxins such as the staphylococcal enterotoxin B (SEB) and A (SEA). Nonetheless the role of SEB and SEA in AD is yet unknown. We analyzed the responsiveness of peripheral blood mononuclear cells (PBMCs) and isolated T cells from donors with AD and from normal donors to SEB and SEA. PBMCs as well as T cells from normal donors showed a significantly enhanced proliferation after stimulation with enterotoxin B, whereas the ³H-thymidine uptake of the T lymphocytes from patients with AD was markedly suppressed. Furthermore, we show that IFN-γ mRNA and protein and mRNA for both chains of IL-12 (p35 and p40) are produced in human PBMCs from normal donors upon stimulation with SEB and SEA. In contrast to normal donors T cells from donors with AD predominantly express mRNA for IL-4, IL-5, and only diminished levels for IFN-γ and IL-12 upon stimulation with SEB and SEA. Furthermore, in contrast to normal donors, PBMCs from donors with AD spontaneously produce high levels of IgE and express increased levels of CD23, the low-affinity receptor for IgE. Nonetheless, the superantigens by themselves, from 0.1 fg up to 1 μg/10⁶ cells, induced neither IgE secretion nor CD23 expression on PBMCs. Moreover, the addition of superantigens to IL-4-treated PBMC cultures diminished or totally suppressed the IL-4-induced IgE synthesis and CD23 expression. No differences were observed between PBMCs from normal donors of donors with AD. Both PBMCs isolated from normal and atopic donors produced high levels of soluble IL-4-receptor (up to 210 ± 90pg/ml). Addition of soluble IL-4-receptor to PBMC cultures downregulated the IL-4-induced IgE synthesis and CD23 expression in unstimulated as well as in SEB-stimulated PBMCs from normal donors and donors with AD. Our results suggest that superantigen-producing staphylococcal strains on the skin of patients with AD may modulate and/or amplify allergic inflammation.

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Section: Discussionmentioning

confidence: 56%

Responsiveness of Peripheral Blood Mononuclear Cells from Normal and Atopic Donors to Microbial Superantigens

König¹,

Neuber²,

König³

1995

Int Arch Allergy Immunol

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“…It inhibits bacterial protein synthesis by binding reversibly and specifically to bacterial isoleucyl transfer-RNA synthetase [1,2]. Because of its excellent antistaphylococcal activity, mupirocin has been used to eradicate nasal carriage of methicillin-resistant Staphylococcus aureus (MRSA) in patients and healthcare workers [3][4][5][6][7][8], in the control of MRSA outbreaks [3,9], in the treatment of infections of wounds, burns, ulcers and eczema [3,7,8,10], as a prophylaxis before skin surgery [11], and for the reduction of staphylococcal load in atopic dermatitis [12,13]. Mupirocin is very safe and does not appear to have any significant side effects.…”

Section: Introductionmentioning

confidence: 99%

Susceptibility of Staphylococci Isolated from a Burns Unit to Mupirocin and Other Antimicrobial Agents

et al. 1998

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The activity of mupirocin (Bactroban) against coagulase-positive and coagulase-negative staphylococci isolated in a burns unit was tested to ascertain its effectiveness, and to detect any resistant isolates after continuous use of mupirocin for 2.5 years. A total of 395 staphylococci, consisting of 330 Staphylococcus aureus and 65 coagulase-negative staphylococci, were tested for resistance to mupirocin and other antimicrobial agents. The results showed that 94.5% of the isolates were fully susceptible to mupirocin (MIC ≤4 mg/l), and 5.3% expressed low-level resistance (MIC 8–128 mg/l). One Staphylococcus haemolyticus isolate expressed high-level resistance (MIC >1,024 mg/l). It transferred high-level mupirocin resistance to other staphylococci in conjugation experiments, which indicated a capacity to transmit mupirocin resistance between species. The results demonstrated that mupirocin was still highly effective against staphylococci in the burns unit. However, the demonstration that the resistant S. haemolyticus isolate could transfer high-level mupirocin resistance to other staphylococci was of concern. There is a compelling need to test staphylococci from clinical materials for mupirocin resistance. Early detection of resistance can prevent the establishment and spread of the mupirocin-resistant strains in the unit.

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