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Susceptibility testing and resistance phenotype detection in Staphylococcus aureus strains isolated from patients with atopic dermatitis, with apparent and recurrent skin colonization.
Br J Dermatol. 2008 Dec; 159(6):1290-9.BJ

Abstract

BACKGROUND

Staphylococcus aureus colonization is accepted to be an important triggering factor in patients with atopic dermatitis (AD) and antibiotic resistance has been recognized to be a serious problem as a consequence and for the management of AD treatment.

OBJECTIVES

To investigate the antibiotic resistance pattern of S. aureus strains isolated from patients with AD with apparent (lesional and nonlesional skin areas) and recurrent skin colonization and strains obtained from healthy nasal carriers.

METHODS

Eighty-seven patients (age 23+/-11.5 years) with mild to severe AD (SCORAD 46.9+/-16.6), 21 patients (age 19.8+/-6.7 years) before antistaphylococcal treatment and 177 healthy nasal carriers (age 27.5+/-8.4 years) were microbiologically assessed for carriage of S. aureus. Colonization of lesional and nonlesional skin areas was quantified by counting the number of colony forming units on the skin surface (log(10) CFU cm(-2)). Antimicrobial susceptibility and resistance phenotypes of 179 S. aureus strains were assessed with the agar disc-diffusion method.

RESULTS

Staphylococcus aureus was isolated from 87% of lesional and 44% of nonlesional skin samples from patients with AD. The colonization density of S. aureus was markedly higher in lesional than in nonlesional skin (P<0.001), and was positively correlated with AD severity (P<0.001) and total serum IgE (P<0.05). Patients with AD had a significantly higher prevalence of chloramphenicol-resistant S. aureus than nasal carriers (P<0.01). Similar rates of resistance were expressed to tetracycline, erythromycin, mupirocin, clindamycin and penicillin. Nearly 35% of S. aureus strains from the lesional skin demonstrated different antimicrobial sensitivity pattern compared with strains from nonlesional skin of the same patients with AD. The trend of increasing resistance to chloramphenicol, erythromycin and fusidic acid was observed among S. aureus strains recovered from patients after approximately 75 days of antibiotic treatment. Methicillin-resistant S. aureus isolates were cultured from two patients, one during exacerbation and the other after subsequent bacterial recolonization.

CONCLUSIONS

Discrepancies in antibiotic sensitivity pattern were observed among S. aureus strains colonizing different sites of AD skin (lesional and nonlesional areas), and also in AD patients with prior antibiotic treatment. Therefore, clinicians should consider repeat microbial susceptibility testing on different body sites of patients with AD when clinically indicated.

Authors+Show Affiliations

Department of Clinical Microbiology, Polish-American Institute of Pediatrics, Jagiellonian University Medical College, and Department of Microbiology, University Hospital, 265 Wielicka Street, 30-663 Cracow, Poland. mmkedzie@cyf-kr.edu.plNo 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

18795934

Citation

Kedzierska, A, et al. "Susceptibility Testing and Resistance Phenotype Detection in Staphylococcus Aureus Strains Isolated From Patients With Atopic Dermatitis, With Apparent and Recurrent Skin Colonization." The British Journal of Dermatology, vol. 159, no. 6, 2008, pp. 1290-9.
Kedzierska A, Kapińska-Mrowiecka M, Czubak-Macugowska M, et al. Susceptibility testing and resistance phenotype detection in Staphylococcus aureus strains isolated from patients with atopic dermatitis, with apparent and recurrent skin colonization. Br J Dermatol. 2008;159(6):1290-9.
Kedzierska, A., Kapińska-Mrowiecka, M., Czubak-Macugowska, M., Wójcik, K., & Kedzierska, J. (2008). Susceptibility testing and resistance phenotype detection in Staphylococcus aureus strains isolated from patients with atopic dermatitis, with apparent and recurrent skin colonization. The British Journal of Dermatology, 159(6), 1290-9. https://doi.org/10.1111/j.1365-2133.2008.08817.x
Kedzierska A, et al. Susceptibility Testing and Resistance Phenotype Detection in Staphylococcus Aureus Strains Isolated From Patients With Atopic Dermatitis, With Apparent and Recurrent Skin Colonization. Br J Dermatol. 2008;159(6):1290-9. PubMed PMID: 18795934.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Susceptibility testing and resistance phenotype detection in Staphylococcus aureus strains isolated from patients with atopic dermatitis, with apparent and recurrent skin colonization. AU - Kedzierska,A, AU - Kapińska-Mrowiecka,M, AU - Czubak-Macugowska,M, AU - Wójcik,K, AU - Kedzierska,J, Y1 - 2008/09/15/ PY - 2008/9/18/pubmed PY - 2009/2/7/medline PY - 2008/9/18/entrez SP - 1290 EP - 9 JF - The British journal of dermatology JO - Br J Dermatol VL - 159 IS - 6 N2 - BACKGROUND: Staphylococcus aureus colonization is accepted to be an important triggering factor in patients with atopic dermatitis (AD) and antibiotic resistance has been recognized to be a serious problem as a consequence and for the management of AD treatment. OBJECTIVES: To investigate the antibiotic resistance pattern of S. aureus strains isolated from patients with AD with apparent (lesional and nonlesional skin areas) and recurrent skin colonization and strains obtained from healthy nasal carriers. METHODS: Eighty-seven patients (age 23+/-11.5 years) with mild to severe AD (SCORAD 46.9+/-16.6), 21 patients (age 19.8+/-6.7 years) before antistaphylococcal treatment and 177 healthy nasal carriers (age 27.5+/-8.4 years) were microbiologically assessed for carriage of S. aureus. Colonization of lesional and nonlesional skin areas was quantified by counting the number of colony forming units on the skin surface (log(10) CFU cm(-2)). Antimicrobial susceptibility and resistance phenotypes of 179 S. aureus strains were assessed with the agar disc-diffusion method. RESULTS: Staphylococcus aureus was isolated from 87% of lesional and 44% of nonlesional skin samples from patients with AD. The colonization density of S. aureus was markedly higher in lesional than in nonlesional skin (P<0.001), and was positively correlated with AD severity (P<0.001) and total serum IgE (P<0.05). Patients with AD had a significantly higher prevalence of chloramphenicol-resistant S. aureus than nasal carriers (P<0.01). Similar rates of resistance were expressed to tetracycline, erythromycin, mupirocin, clindamycin and penicillin. Nearly 35% of S. aureus strains from the lesional skin demonstrated different antimicrobial sensitivity pattern compared with strains from nonlesional skin of the same patients with AD. The trend of increasing resistance to chloramphenicol, erythromycin and fusidic acid was observed among S. aureus strains recovered from patients after approximately 75 days of antibiotic treatment. Methicillin-resistant S. aureus isolates were cultured from two patients, one during exacerbation and the other after subsequent bacterial recolonization. CONCLUSIONS: Discrepancies in antibiotic sensitivity pattern were observed among S. aureus strains colonizing different sites of AD skin (lesional and nonlesional areas), and also in AD patients with prior antibiotic treatment. Therefore, clinicians should consider repeat microbial susceptibility testing on different body sites of patients with AD when clinically indicated. SN - 1365-2133 UR - https://www.unboundmedicine.com/medline/citation/18795934/Susceptibility_testing_and_resistance_phenotype_detection_in_Staphylococcus_aureus_strains_isolated_from_patients_with_atopic_dermatitis_with_apparent_and_recurrent_skin_colonization_ L2 - https://doi.org/10.1111/j.1365-2133.2008.08817.x DB - PRIME DP - Unbound Medicine ER -