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Persistent skin colonization with Staphylococcus aureus in atopic dermatitis: relationship to clinical and immunological parameters.
Clin Exp Allergy. 2005 Apr; 35(4):448-55.CE

Abstract

BACKGROUND

Staphylococcus aureus has important implications for the pathogenesis of atopic dermatitis (AD). In some patients S. aureus can be eradicated from the skin during anti-inflammatory treatment, while in others bacterial colonization is persistent. Potential mechanisms and features of these two distinct groups of patients are not known.

OBJECTIVE

Accordingly, we studied relationships between the ability to eliminate S. aureus during an anti-inflammatory treatment and selected clinical and immunological features.

METHODS

Quantitative assessment of S. aureus on the skin, in nasal vestibule and throat, serum IgE levels, CD4/CD8 T-cell ratio, lymphocyte proliferation and phagocyte oxidative burst were determined during the exacerbation and after 4 and 12 weeks of the treatment using topical steroid and oral antihistamine in 34 patients with AD.

RESULTS

S. aureus was found on the skin of all 34 patients during exacerbation. Disease severity scoring of atopic dermatitis (SCORAD) correlated with the density of bacteria. Treatment with oral antihistamine and topical steroid resulted in a significant alleviation of symptoms, which correlated with the elimination of S. aureus from the skin in 70% of patients. In the remaining 30% of patients, dense (more than 10(10)/cm2) S. aureus skin colonization, persisted despite the treatment. Patients with persistent S. aureus presented with higher serum IgE levels, lower lymphocyte proliferation in response to staphylococcal enterotoxin B, phytohaemagluttinin and anti-CD3. Persistence of S. aureus was more common in men.

CONCLUSIONS

Patients with AD differ in the ability to clear S. aureus from the skin during anti-inflammatory treatment, which appears to be related to the abnormalities in immunological parameters. Local antibiotic therapy should be considered only in patients with persistent S. aureus colonization.

Authors+Show Affiliations

Department of Medicine, Jagiellonian University of Medicine, Cracow, Poland. tguzik@well.ox.ac.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15836752

Citation

Guzik, T J., et al. "Persistent Skin Colonization With Staphylococcus Aureus in Atopic Dermatitis: Relationship to Clinical and Immunological Parameters." Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology, vol. 35, no. 4, 2005, pp. 448-55.
Guzik TJ, Bzowska M, Kasprowicz A, et al. Persistent skin colonization with Staphylococcus aureus in atopic dermatitis: relationship to clinical and immunological parameters. Clin Exp Allergy. 2005;35(4):448-55.
Guzik, T. J., Bzowska, M., Kasprowicz, A., Czerniawska-Mysik, G., Wójcik, K., Szmyd, D., Adamek-Guzik, T., & Pryjma, J. (2005). Persistent skin colonization with Staphylococcus aureus in atopic dermatitis: relationship to clinical and immunological parameters. Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology, 35(4), 448-55.
Guzik TJ, et al. Persistent Skin Colonization With Staphylococcus Aureus in Atopic Dermatitis: Relationship to Clinical and Immunological Parameters. Clin Exp Allergy. 2005;35(4):448-55. PubMed PMID: 15836752.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Persistent skin colonization with Staphylococcus aureus in atopic dermatitis: relationship to clinical and immunological parameters. AU - Guzik,T J, AU - Bzowska,M, AU - Kasprowicz,A, AU - Czerniawska-Mysik,G, AU - Wójcik,K, AU - Szmyd,D, AU - Adamek-Guzik,T, AU - Pryjma,J, PY - 2005/4/20/pubmed PY - 2005/7/12/medline PY - 2005/4/20/entrez SP - 448 EP - 55 JF - Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology JO - Clin Exp Allergy VL - 35 IS - 4 N2 - BACKGROUND: Staphylococcus aureus has important implications for the pathogenesis of atopic dermatitis (AD). In some patients S. aureus can be eradicated from the skin during anti-inflammatory treatment, while in others bacterial colonization is persistent. Potential mechanisms and features of these two distinct groups of patients are not known. OBJECTIVE: Accordingly, we studied relationships between the ability to eliminate S. aureus during an anti-inflammatory treatment and selected clinical and immunological features. METHODS: Quantitative assessment of S. aureus on the skin, in nasal vestibule and throat, serum IgE levels, CD4/CD8 T-cell ratio, lymphocyte proliferation and phagocyte oxidative burst were determined during the exacerbation and after 4 and 12 weeks of the treatment using topical steroid and oral antihistamine in 34 patients with AD. RESULTS: S. aureus was found on the skin of all 34 patients during exacerbation. Disease severity scoring of atopic dermatitis (SCORAD) correlated with the density of bacteria. Treatment with oral antihistamine and topical steroid resulted in a significant alleviation of symptoms, which correlated with the elimination of S. aureus from the skin in 70% of patients. In the remaining 30% of patients, dense (more than 10(10)/cm2) S. aureus skin colonization, persisted despite the treatment. Patients with persistent S. aureus presented with higher serum IgE levels, lower lymphocyte proliferation in response to staphylococcal enterotoxin B, phytohaemagluttinin and anti-CD3. Persistence of S. aureus was more common in men. CONCLUSIONS: Patients with AD differ in the ability to clear S. aureus from the skin during anti-inflammatory treatment, which appears to be related to the abnormalities in immunological parameters. Local antibiotic therapy should be considered only in patients with persistent S. aureus colonization. SN - 0954-7894 UR - https://www.unboundmedicine.com/medline/citation/15836752/Persistent_skin_colonization_with_Staphylococcus_aureus_in_atopic_dermatitis:_relationship_to_clinical_and_immunological_parameters_ L2 - https://doi.org/10.1111/j.1365-2222.2005.02210.x DB - PRIME DP - Unbound Medicine ER -