Skin and nasal vestibule colonisation by Staphylococcus aureus and its susceptibility to drugs in atopic dermatitis patients

Abstract

Introduction. Atopic dermatitis (AD) is a chronic and recurrent disease with an inflammatory background. Genetic and environmental factors are responsible for the occurrence and development of this dermatosis. Objective. The aim of the study was to assess the frequency of colonisation of the nasal vestibule and apparently healthy skin by S. aureus, and to assess dermal lesions for superinfection with S. aureus in AD patients. Materials and method. The research was performed on a population of 100 AD patients. Three smears were collected for microbiological investigations: from the anterior nares, from apparently healthy skin and from lesioned skin. On collection, the material was cultured on mediums provided by the bioMerieux and Argenta companies. The strains were identified and their sensitivity to antibiotics assessed by means of the Vitek2 system (bioMerieux). Results. S. aureus was present in at least one location in 90%. 44% presented S. aureus colonization of apparently healthy skin and within skin lesions. In the case of 23%, this particular pathogen was detected only in skin lesions, whereas 6% had a positive result within the area of apparently healthy skin. In total, S. aureus was detected in the skin of 73%. In 61%, apparently healthy skin had been colonized with S. aureus, whereas in 81% colonization was proved within the skin lesions. S. aureus was detected in the nasal vestibule of 85%. Among the group with S. aureus in their anterior nares, the pathogen was also found on the skin surface of 77%. Conclusions. S. aureus colonises skin in most AD patients. Most AD patients carry S. aureus in their nasal vestibules. S. aureus does not seem to colonise healthy skin as often as skin lesions in young people. The vast majority of S. aureus strains were sensitive to local antibiotics. Most S. aureus strains produced penicillinase.

Molecular Epidemiology of Staphylococcus aureus in African Children from Rural and Urban Communities with Atopic Dermatitis

“…10,33 With respect to sampling site-speci c colonisation, AD-lesional skin has been shown to be more susceptible to S. aureus colonisation compared to AD-uninvolved, non-lesional skin, with a reported prevalence of colonisation of 23-70% vs. 6-39%. 10,34,35 Similarly, we noted higher frequency of colonisation on lesional skin compared to non-lesional skin among urban cases, but not in rural cases. Further, similar colonisation rates on lesional skin and anterior nares have been reported in AD with nasal colonisation thought to be the main source of the increased skin colonisation in AD.…”

Changes in Skin and Nasal Microbiome and Staphylococcal Species Following Treatment of Atopic Dermatitis with Dupilumab

“…At present, mechanistic evidence suggests that S. aureus is mutually promoted by and aggravated by Th2-mediated inflammation and skin barrier impairment in AD [ 10 , 35 ]. However, previous studies that evaluated the efficacy of topical antibiotics showed conflicting results [ 36 , 37 ], and it has been hypothesized that this may be due to recolonization by nasal S. aureus and eradication of beneficial bacteria [ 38 , 39 ]. Ongoing research is working with manipulating the skin microbiome in the therapeutic management of AD [ 40 , 41 ], and initial pilot trials showed that topical application of coagulase negative staphylococci (CoNS) [ 40 ] and Roseomonas mucosa [ 42 ] decreased disease severity.…”

On the surface

“…85 A study sampling S aureus from both children and adults revealed that 85% of the subjects were colonized with S aureus in the nares and approximately 77% of the subjects with AD colonized by S aureus in the nares were also colonized on the skin. 86 These findings suggest that S aureus proliferates in the nasal cavity and a connection exists between the biomes at these 2 surfaces.…”