Temporal Variation in <b><i>Staphylococcus aureus</i></b> Protein A Genotypes from Nose and Skin in Atopic Dermatitis Patients

Abstract

&lt;b&gt;&lt;i&gt;Background:&lt;/i&gt;&lt;/b&gt; &lt;i&gt;Staphylococcus aureus&lt;/i&gt; colonization is associated with disease severity in patients with atopic dermatitis (AD). &lt;b&gt;&lt;i&gt;Objective:&lt;/i&gt;&lt;/b&gt; To investigate temporal variation in &lt;i&gt;S. aureus&lt;/i&gt; protein A gene (&lt;i&gt;spa)&lt;/i&gt;-types isolated from the nose and lesional skin and the correlation of &lt;i&gt;spa&lt;/i&gt;-types with disease severity. &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; This study included 96 adult AD patients who were assessed at baseline (T0) and after a strict 2-week follow-up period (T1) in which treatment was standardized with a topical corticosteroid. Fifty-five different &lt;i&gt;spa&lt;/i&gt;-types were detected in the nose and skin cultures. Seventy-three patients were colonized with &lt;i&gt;S. aureus&lt;/i&gt; in the nasal cavity at both time points (persistent carriership), 59 of whom (81%) had identical &lt;i&gt;spa&lt;/i&gt;-types over time. For skin samples, 42 (75%) of the 56 persistent skin carriers had identical &lt;i&gt;spa&lt;/i&gt;-types over time. The same &lt;i&gt;spa&lt;/i&gt;-type was carried in the nose and skin in 79 and 77% of the patients at T0 and T1, respectively. More severe disease was not associated with specific &lt;i&gt;spa&lt;/i&gt;-types or with temporal variation in &lt;i&gt;spa&lt;/i&gt;-type. &lt;b&gt;&lt;i&gt;Conclusion:&lt;/i&gt;&lt;/b&gt; &lt;i&gt;S. aureus&lt;/i&gt; strains in AD are highly heterogeneous between patients. The majority of patients carry the same &lt;i&gt;spa&lt;/i&gt;-type in the nose and skin without temporal variation, suggesting clonal colonization within individual patients. No predominant &lt;i&gt;spa&lt;/i&gt;-type or temporal variation is associated with increased disease severity.

Staphylococcus aureus Adaptation to the Skin in Health and Persistent/Recurrent Infections

“…Among these patients, isolates from CC1, CC15, and CC45 were predominant [94]. Similar findings were obtained by van Mierlo et al in a population of 96 adults with AD from the Netherlands [104]. Benito et al also observed colonization of each individual with only one CC but reported a high clonal diversity among skin isolates compared with nasal isolates in AD patients from Spain.…”

Staphylococcus aureus from Atopic Dermatitis Patients: Its Genetic Structure and Susceptibility to Phototreatment

“…In studies described in 2021 by Masiuk et al ( 42 ), only two of 16 S. aureus from AD patients had a different genotype when nose and skin isolates were compared. Similarly, most AD patients have been found to be persistent S. aureus carriers with identical spa types in the nose and skin ( 43 ). The authors of previously published studies have also noted a high percentage of related skin and nasal isolates when they originated from one patient ( 4 , 44 , 45 ).…”

Circulating Antibodies to Skin Bacteria Detected by Serological Lateral Flow Immunoassays Differentially Correlated With Bacterial Abundance

“…S. aureus is frequently isolated from the anterior nares, which is assumed to be the main reservoir for the spread of the pathogen-associated skin diseases such as atopic dermatitis ( van Mierlo et al, 2021 ). However, several S. aureus strains have been collected from pus cell of nodulocystic and pustular acne of volunteers ( Khan et al, 2015 ).…”

“…It has been shown that there is a systemic humoral response against commensal bacteria in healthy individuals (Sterlin et al, 2020). To examine the correlation between the abundance of bacteria and their antibody titers in humans, the level of IgG toward the antigens of C. acnes, S. aureus, and C. aurimucosum was evaluated by the reactivity of the human sera with the corresponding bacterial lysates.…”