Variation in Staphylococcus aureus Colonization in Relation to Disease Severity in Adults with Atopic Dermatitis during a Five-month Follow-up

Abstract

The aim of this study was to monitor Staphylococcus aureus colonization and disease severity in adults with atopic dermatitis (AD) during 5 months. Twenty-one patients attended 3 visits each for severity SCORing of Atopic Dermatitis (SCORAD) assessment, quantitative cultures from the skin and conventional cultures from the anterior nares, tonsils and perineum. S. aureus isolates were typed for strain identity with pulsed-field gel electrophoresis (PFGE). Seventy-one percent of patients were colonized with S. aureus on lesional skin at least once. Density (colony-forming units (CFU)/cm2) was higher on lesional skin than on non-lesional skin (p < 0.05). Density on lesional skin and number of colonized body sites were positively correlated with SCORAD (p = 0.0003 and p = 0.007, respectively). Persistent carriers of the same strain on lesional skin had higher mean SCORAD index than intermittent/non-carriers (36.3 and 17.1, respectively, p = 0.002). The results show a temporal correlation between several aspects of S. aureus colonization and disease severity in AD raising the question of the importance of this in pathogenesis and treatment.

Quorum sensing between bacterial species on the skin protects against epidermal injury in atopic dermatitis

“…Furthermore, recent studies of the composition of the skin microbial community have suggested that a relative abundance of bacteria such as Staphylococcus aureus and coagulase-negative staphylococcal (CoNS) species may predict the development of AD (6,7). These observations follow several decades of reports that S. aureus often colonizes lesions on the skin of patients with AD (8) and positively correlates with disease severity (9)(10)(11). Despite the large body of work to identify genetic, environmental, and microbial risk factors that may cause AD, there is as of yet no validated, cohesive hypothesis to link these observations together into a unifying pathophysiologic mechanism.…”

Temporal variation of Staphylococcus aureus clonal complexes in atopic dermatitis: a follow‐up study

“…Although colonization with S. aureus is generally accepted to be associated with increased severity and flares of AD, only a few studies have examined the temporal variation of colonization and spa and CC types and related this to disease severity. Our findings that only 57% of patients initially colonized with S. aureus were colonized when re‐examined after 1·5–4 years, and that 43% were colonized at only one visit, illustrate that colonization changes over time.…”

“…Even though colonization rates are high in AD, temporal variation of S. aureus clonal complex (CC) types in patients with AD has sparsely been investigated and only over short periods of time . Staphylococcus aureus is very clonal, and most patients with AD are colonized with only one CC type .…”

T helper 22 cells from Han Chinese patients with atopic dermatitis exhibit high expression of inducible T‐cell costimulator

“…31,32 There is a positive correlation between disease severity and S. aureus colonization of lesional and nonlesional skin in patients with AD. 32 The toxins produced by S. aureus may aggravate AD by acting as superantigens, which can activate T cells and result in the overproduction of cytokines and systemic inflammation and shock. 33 In our previous research, we demonstrated that the S. aureus toxins SEB and SEA significantly enhance the proliferative response and the release of IL-4, IL-5, IL-13 and TNF-a as well as interferon-c in the peripheral blood of patients with AD in a Chinese Han population.…”