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- Title
Persistent skin colonization withStaphylococcus aureusin atopic dermatitis: relationship to clinical and immunological parameters.
- Authors
Guzik, T. J.; Bzowska, M.; Kasprowicz, A.; Czerniawska-Mysik, G.; Wójcik, K.; Szmyd, D.; Adamek-Guzik, T.; Pryjma, J.
- Abstract
Staphylococcus aureushas important implications for the pathogenesis of atopic dermatitis (AD). In some patientsS. aureuscan 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.Accordingly, we studied relationships between the ability to eliminateS. aureusduring an anti-inflammatory treatment and selected clinical and immunological features.Quantitative assessment ofS. aureuson 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.S. aureuswas 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 ofS. aureusfrom the skin in 70% of patients. In the remaining 30% of patients, dense (more than 1010/cm2)S. aureusskin colonization, persisted despite the treatment. Patients with persistentS. aureuspresented with higher serum IgE levels, lower lymphocyte proliferation in response to staphylococcal enterotoxin B, phytohaemagluttinin and anti-CD3. Persistence ofS. aureuswas more common in men.Patients with AD differ in the ability to clearS. aureusfrom 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 persistentS. aureuscolonization.
- Subjects
STAPHYLOCOCCUS aureus; ATOPIC dermatitis; COMPETITIVE exclusion (Microbiology); SKIN inflammation; STEROID drugs; ENTEROTOXINS
- Publication
Clinical & Experimental Allergy, 2005, Vol 35, Issue 4, p448
- ISSN
0954-7894
- Publication type
Article
- DOI
10.1111/j.1365-2222.2005.02210.x