Susceptibility testing and resistance phenotype detection in<i>Staphylococcus aureus</i>strains isolated from patients with atopic dermatitis, with apparent and recurrent skin colonization

Kędzierska, Anna; Kapińska-Mrowiecka, Monika; Czubak-Macugowska, Marzena; Wójcik, Kinga; Kędzierska, Jolanta

doi:10.1111/j.1365-2133.2008.08817.x

Cited by 43 publications

(34 citation statements)

References 30 publications

(61 reference statements)

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“…Nonlesional skin also exhibited decreased diversity relative to controls, suggesting an altered cutaneous microbiota beyond clinically affected skin in AD patients. While culture-based studies have shown increased rates of Staphylococcus colonization on nonlesional skin, 29,30 molecular characterization of the nonlesional cutaneous microbiome and how it differs from control skin using both qPCR and 16Ss sequencing had not been reported.…”

Section: Discussionmentioning

confidence: 99%

Cutaneous microbiome effects of fluticasone propionate cream and adjunctive bleach baths in childhood atopic dermatitis

González

Schaffer

Orlow

et al. 2016

Journal of the American Academy of Dermatology

137

135

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Background Patients with atopic dermatitis (AD) are prone to skin infections, with microbes like Staphylococcus aureus suspected of contributing to pathogenesis. Bleach baths might improve AD by reducing skin microbial burden. Objective To characterize the microbiota of lesional and nonlesional skin in young children with AD and controls and compare changes after treatment with a topical corticosteroid (TCS) alone or TCS + dilute bleach baths (BB). Methods In a randomized, placebo-controlled, single-blinded clinical trial in 21 children with AD and 14 healthy children, lesional and nonlesional AD skin was examined at baseline and after 4-week treatment with TCS alone or TCS plus BB. Microbial DNA was extracted for qPCR of predominant genera and 16S rRNA sequencing. Results At baseline, densities of total bacteria and Staphylococcus, including S. aureus, were significantly higher at the worst AD lesional site than nonlesional (p=0.001) or control (p<0.001) skin; bacterial communities on lesional and nonlesional AD skin significantly differed from each other (p=0.04) and from control (p<0.001). After TCS + BB or TCS alone, bacterial compositions on lesional skin normalized (p<0.0001), resembling nonlesional skin, with microbial diversity restored to control skin levels. Limitations The 4-week time period and/or the twice-weekly baths may not have been sufficient for additional impact on the cutaneous microbiome. More detailed sequencing may allow better characterization of the distinguishing taxa with BB-treatment. Conclusions Treatment with a topical corticosteroid cream suffices to normalize the cutaneous microbiota on lesional AD; after treatment, bacterial communities on lesional skin resemble nonlesional skin but remain distinct from control.

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Section: Discussionmentioning

confidence: 99%

Cutaneous microbiome effects of fluticasone propionate cream and adjunctive bleach baths in childhood atopic dermatitis

González

Schaffer

Orlow

et al. 2016

Journal of the American Academy of Dermatology

137

135

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“…Atopic dermatitis (AD), a common form of eczema, affects up to 20% of children in the US, and is widely accepted to have a profound defect in the stratum corneum function and increased transepidermal water loss (Choi and Maibach, 2005; Imokawa, 2001; Jungersted et al ., 2008; Laughter et al ., 2000; Murata et al ., 1996; Pilgram et al ., 2001). AD patients are far more susceptible to skin infections by organisms such as Staphlococcus aureus and Herpes simplex (Kedzierska et al ., 2008; Lebre et al ., 2008; Niebuhr et al ., 2008; Scott et al ., 2007). It has been speculated that AD individuals would be more susceptible to severe radiation skin injury, however the definitive answer has yet to be elucidated.…”

Section: Current Understanding: Perception Of Radiation Skin Injurymentioning

confidence: 99%

Ionizing Radiation: The Good, the Bad, and the Ugly

Ryan

2012

Journal of Investigative Dermatology

379

371

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Skin changes from ionizing radiation have been scientifically documented since 1902 (Hymes et al., 2006). Ionizing radiation is a widely accepted form of treatment for various types of cancer. Despite the technological advances, radiation skin injury remains a significant problem. This injury, often referred to as radiation dermatitis, occurs in about 95% of patients receiving radiation therapy for cancer and ranges in severity from mild erythema to moist desquamation and ulceration (McQuestion, 2011; Salvo et al., 2010). Ionizing radiation is not only a concern for cancer patients, but also a public health concern due to the potential for and reality of a nuclear and/or radiological event. Recently, the United States has increased efforts to develop medical countermeasures to protect against radiation toxicities from acts of bioterrorism, as well as cancer treatment. Management of radiation dermatitis would improve the therapeutic benefit of radiation therapy for cancer and potentially the mortality expected in any “dirty bomb” attack (Benderitter et al., 2010; Muller and Meineke, 2010). Currently, there is no effective treatment to prevent or mitigate radiation skin injury. This review summarizes “the good, the bad and the ugly” of current and evolving knowledge regarding mechanisms of and treatments for radiation skin injury.

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“…However, the benefit of antibiotic use in AD is still disputed with a Cochrane review presenting studies showing no significant difference in global outcome for clinically infected eczema when oral antibiotics were compared with placebo or when topical steroid antibiotic combinations were compared with steroid alone [50]. Given the contradictory results available, it would be prudent to be restrictive in prescribing antibiotics, mainly because of an increasing resistance problem worldwide [55, 56, 57, 58]. …”

Section: The Rationale For Antiseptic Use In Atopic Eczemamentioning

confidence: 99%

The role of antiseptic agents in atopic dermatitis

Lee¹,

Bever²

2014

Asia Pacific Allergy

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The skin of individuals with atopic dermatitis has a susceptibility to be colonized with Staphylococcus aureus. This has been associated with increased frequency and severity of exacerbations of atopic dermatitis. Therefore, there is a growing interest in the use of antiseptic agents to target primary bacterial colonization and infection. Antiseptic agents have been found to be better tolerated and less likely to induce bacterial resistance as compared to antibiotics. There is also a wide variety of antiseptic agents available. The efficacy of antiseptic agents has yet to be established as the studies reviewed previously have been small and of suboptimal quality. This review discusses the rationale behind targeting S. aureus with antiseptic agents and presents findings from a review of studies assessing the efficacy of antiseptics in atopic dermatitis in the last five years. Four studies were found, including a bleach bath study which has already been reviewed elsewhere. The remaining 3 studies assessed the efficacy of sodium hypochlorite containing cleansing body wash, sodium hypochlorite baths and 1% triclosan in leave on emollient. These studies suggested some benefit for the inclusion of antiseptic use with the mainstay management of atopic dermatitis, including a potential steroid sparring effect. However, there are many limitations to these studies which therefore warrant further investigation on the impact of antiseptic use in atopic dermatitis.

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Susceptibility testing and resistance phenotype detection inStaphylococcus aureusstrains isolated from patients with atopic dermatitis, with apparent and recurrent skin colonization

Cited by 43 publications

References 30 publications

Cutaneous microbiome effects of fluticasone propionate cream and adjunctive bleach baths in childhood atopic dermatitis

Cutaneous microbiome effects of fluticasone propionate cream and adjunctive bleach baths in childhood atopic dermatitis

Ionizing Radiation: The Good, the Bad, and the Ugly

The role of antiseptic agents in atopic dermatitis

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