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Prevalence of community-acquired methicillin-resistant Staphylococcus aureus and antibiotic resistance in patients with atopic dermatitis in Porto Alegre, Brazil.
Int J Dermatol. 2014 Jun; 53(6):731-5.IJ

Abstract

BACKGROUND

Atopic dermatitis (AD) is a skin manifestation of atopy caused by hyperreactivity to various antigens. Studies have shown that 60-100% of patients with this condition present with colonization by Staphylococcus aureus. Given increasing rates of antimicrobial resistance, the sensitivity to antimicrobials of S. aureus colonizing atopic patients has been investigated. Cross-sectional studies worldwide suggest that the prevalence of methicillin-resistant S. aureus infection (MRSA) in the AD population varies from 0% to 30.8%.

OBJECTIVES

The objectives of this study were to determinate the prevalence of S. aureus and MRSA in patients with AD in two dermatologic centers in Porto Alegre, Brazil.

METHODS

A total of 91 patients with AD attending two dermatologic centers in Porto Alegre were enrolled in this study from December 2009 to July 2011. Two skin swabs were taken from each patient, one from the nares and the other from a non-infected eczematous skin lesion. The swabs were sent to the laboratory, where standard procedures to isolate bacteria and identify S. aureus, antimicrobial resistance, and sensitivity patterns were carried out. The severity of AD was defined using the Eczema Area and Severity Index (EASI).

RESULTS

Of the 91 patients sampled, 67 (73.6%) patients were found to be positive for S. aureus colonization. Nasal swabs were positive in 55 (60.4%) patients, lesional swabs in 44 (48.4%) patients, and both lesional and nasal swabs were positive in 32 (35.2%) patients. Patients with positive swabs had a higher mean ± standard deviation EASI score [mean (9.1 ± 8.8)] compared with patients with negative swabs (3.9 ± 3.6) (P = 0.002). None of the 91 patients showed any evidence of MRSA infection. Overall, nearly 32% of the S. aureus isolated from nasal swabs and 36.40% of the S. aureus isolated from lesional swabs was resistant to erythromycin.

CONCLUSIONS

The results of this study confirm a high rate of S. aureus colonization in pediatric patients with AD and indicate a relevant association between colonization and high EASI score. No MRSA was found in cultures from this sample of patients in southern Brazil. Nearly one-third of isolates were identified as resistant to erythromycin, an antibiotic that is commonly used in pediatric patients.

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Authors+Show Affiliations

Petry V
Department of Dermatology, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.
Lipnharski C
No affiliation info available
Bessa GR
No affiliation info available
Silveira VB
No affiliation info available
Weber MB
No affiliation info available
Bonamigo RR
No affiliation info available
d'Azevedo PA
No affiliation info available

MeSH

AdolescentAdultAge DistributionAnalysis of VarianceAnti-Bacterial AgentsBrazilChi-Square DistributionChildChild, PreschoolCommunity-Acquired InfectionsCross-Sectional StudiesDermatitis, AtopicDrug Resistance, BacterialFemaleHumansInfantMaleMethicillin-Resistant Staphylococcus aureusMicrobial Sensitivity TestsPrevalenceProspective StudiesSeverity of Illness IndexSex DistributionStaphylococcal Skin InfectionsYoung Adult

Pub Type(s)

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

Language

eng

PubMed ID

24168078

Citation

Petry, Vanessa, et al. "Prevalence of Community-acquired Methicillin-resistant Staphylococcus Aureus and Antibiotic Resistance in Patients With Atopic Dermatitis in Porto Alegre, Brazil." International Journal of Dermatology, vol. 53, no. 6, 2014, pp. 731-5.
Petry V, Lipnharski C, Bessa GR, et al. Prevalence of community-acquired methicillin-resistant Staphylococcus aureus and antibiotic resistance in patients with atopic dermatitis in Porto Alegre, Brazil. Int J Dermatol. 2014;53(6):731-5.
Petry, V., Lipnharski, C., Bessa, G. R., Silveira, V. B., Weber, M. B., Bonamigo, R. R., & d'Azevedo, P. A. (2014). Prevalence of community-acquired methicillin-resistant Staphylococcus aureus and antibiotic resistance in patients with atopic dermatitis in Porto Alegre, Brazil. International Journal of Dermatology, 53(6), 731-5. https://doi.org/10.1111/ijd.12020
Petry V, et al. Prevalence of Community-acquired Methicillin-resistant Staphylococcus Aureus and Antibiotic Resistance in Patients With Atopic Dermatitis in Porto Alegre, Brazil. Int J Dermatol. 2014;53(6):731-5. PubMed PMID: 24168078.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence of community-acquired methicillin-resistant Staphylococcus aureus and antibiotic resistance in patients with atopic dermatitis in Porto Alegre, Brazil. AU - Petry,Vanessa, AU - Lipnharski,Caroline, AU - Bessa,Giancarlo R, AU - Silveira,Vera B, AU - Weber,Magda B, AU - Bonamigo,Renan R, AU - d'Azevedo,Pedro A, Y1 - 2013/10/29/ PY - 2013/10/31/entrez PY - 2013/10/31/pubmed PY - 2015/1/8/medline SP - 731 EP - 5 JF - International journal of dermatology JO - Int J Dermatol VL - 53 IS - 6 N2 - BACKGROUND: Atopic dermatitis (AD) is a skin manifestation of atopy caused by hyperreactivity to various antigens. Studies have shown that 60-100% of patients with this condition present with colonization by Staphylococcus aureus. Given increasing rates of antimicrobial resistance, the sensitivity to antimicrobials of S. aureus colonizing atopic patients has been investigated. Cross-sectional studies worldwide suggest that the prevalence of methicillin-resistant S. aureus infection (MRSA) in the AD population varies from 0% to 30.8%. OBJECTIVES: The objectives of this study were to determinate the prevalence of S. aureus and MRSA in patients with AD in two dermatologic centers in Porto Alegre, Brazil. METHODS: A total of 91 patients with AD attending two dermatologic centers in Porto Alegre were enrolled in this study from December 2009 to July 2011. Two skin swabs were taken from each patient, one from the nares and the other from a non-infected eczematous skin lesion. The swabs were sent to the laboratory, where standard procedures to isolate bacteria and identify S. aureus, antimicrobial resistance, and sensitivity patterns were carried out. The severity of AD was defined using the Eczema Area and Severity Index (EASI). RESULTS: Of the 91 patients sampled, 67 (73.6%) patients were found to be positive for S. aureus colonization. Nasal swabs were positive in 55 (60.4%) patients, lesional swabs in 44 (48.4%) patients, and both lesional and nasal swabs were positive in 32 (35.2%) patients. Patients with positive swabs had a higher mean ± standard deviation EASI score [mean (9.1 ± 8.8)] compared with patients with negative swabs (3.9 ± 3.6) (P = 0.002). None of the 91 patients showed any evidence of MRSA infection. Overall, nearly 32% of the S. aureus isolated from nasal swabs and 36.40% of the S. aureus isolated from lesional swabs was resistant to erythromycin. CONCLUSIONS: The results of this study confirm a high rate of S. aureus colonization in pediatric patients with AD and indicate a relevant association between colonization and high EASI score. No MRSA was found in cultures from this sample of patients in southern Brazil. Nearly one-third of isolates were identified as resistant to erythromycin, an antibiotic that is commonly used in pediatric patients. SN - 1365-4632 UR - https://www.unboundmedicine.com/medline/citation/24168078/Prevalence_of_community_acquired_methicillin_resistant_Staphylococcus_aureus_and_antibiotic_resistance_in_patients_with_atopic_dermatitis_in_Porto_Alegre_Brazil_ L2 - https://doi.org/10.1111/ijd.12020 DB - PRIME DP - Unbound Medicine ER -