Staphylococcus aureus colonization related to severity of hand eczema

Abstract

Knowledge on Staphylococcus aureus colonization rates and epidemiology in hand eczema is limited. The aim of this study was to clarify some of these issues. Samples were collected by the "glove juice" method from the hands of 59 patients with chronic hand eczema and 24 healthy individuals. Swab samples were taken from anterior nares and throat from 43 of the 59 patients and all healthy individuals. S. aureus were spa typed and analysed by DNA-microarray-based genotyping. The extent of the eczema was evaluated by the hand eczema extent score (HEES). The colonization rate was higher on the hands of hand eczema patients (69 %) compared to healthy individuals (21 %, p < 0.001). This was also seen for bacterial density (p = 0.002). Patients with severe hand eczema (HEES ≥ 13) had a significantly higher S. aureus density on their hands compared to those with milder eczema (HEES = 1 to 12, p = 0.004). There was no difference between patients and healthy individuals regarding colonization rates in anterior nares or throat. spa typing and DNA-microarray-based genotyping indicated certain types more prone to colonize eczematous skin. Simultaneous colonization, in one individual, with S. aureus of different types, was identified in 60-85 % of the study subjects. The colonization rate and density indicate a need for effective treatment of eczema and may have an impact on infection control in healthcare.

Review—Current Concepts in Inflammatory Skin Diseases Evolved by Transcriptome Analysis: In-Depth Analysis of Atopic Dermatitis and Psoriasis

“…In contrast, the skin microbiome of AD patients was highly over-represented by Staphylococcus (S.) aureus which allowed the discrimination of a S. aureus "low" and "high" colonized state. The latter one was shown to be paralleled by increased barrier dysfunction (e.g., CLDN8, FLG) and a stronger immune cell related profile (e.g., IL13, IL5) [148,151]. This identified "high" colonized state may also be more prone to HSV-1 infections as it is seen in ADEH+ patients [88].…”

Hand eczema: epidemiology, prognosis and prevention

“…Patients with HE due to or aggravated by work-related exposures may have to change job or modify working routines to reduce the burden on the skin. More than half of all HE patients are colonized by bacteria (Staphylococcus aureus), 3,4 the risk of colonization being strongly related to severity of the disease. This creates a problem for individuals working with food where contamination is a risk, and for individuals working in the healthcare sector, where transmission of bacteria to patients may be a consequence.…”

Hand eczema in nurses, nursing auxiliaries and cleaners—A cross‐sectional study from a tertiary hospital in western India

“…Healthcare workers, especially nurses, nursing auxiliaries, and hospital cleaning staff, often bear the maximum burden of occupational contact dermatitis, owing to frequent “wet work” and daily contact with both irritants and allergens, leading to chronic absenteeism, increased health costs, and an impaired quality of life (QoL) . Hand eczema may also lead to increased carriage of hazardous microorganisms, making it a potential route for transmission of infection …”

“…[1][2][3][4][5] Hand eczema may also lead to increased carriage of hazardous microorganisms, making it a potential route for transmission of infection. 6 The prevalence of hand eczema among hospital workers in countries other than India ranges from 6% to 80%. [7][8][9][10][11][12][13][14][15][16][17][18] However, most studies on hand eczema have been based on self-reported surveys, and have utilized varied outcome measures, and almost no epidemiological data on hand eczema among healthcare workers exist in India.…”