title: Staphylococcal skin colonization in children with atopic dermatitis: prevalence, persistence, and transmission of toxigenic and nontoxigenic strains.
abstract: Staphylococcal skin colonization is a common feature of atopic dermatitis (AD) in adults. Little is known about prevalence and persistence of staphylococci in children. Forty-one AD children (mean age, 70 months) and 41 age-matched controls were studied. S. aureus was isolated from 38 AD patients (93%; 32% of controls, P less than .001) and 37% of AD patients (5% of controls, P less than .001) harbored toxigenic (enterotoxins, toxic shock syndrome toxin) S. aureus strains. No individual biotype prevailed. On follow-up (mean interval, 9 months), 70% of S. aureus strains were reisolated. Nasal and cutaneous S. aureus strains were identical in 73% of AD patients (7% of controls, P less than .001), reflecting increased self-contamination. Identical staphylococcal strains in AD children and their mothers were observed in 38% (S. aureus) and 16% (coagulase-negative strains; P less than .001). The prevalence of staphylococcal colonization in AD children is comparable to that in adults. High rates of self-contamination, transmission to contacts, and prevalence of toxigenic strains in AD children may have clinical and epidemiologic implications.
authors.affiliation: Department of Pediatrics, University of Hamburg, Germany.
authors.forename: P H
authors.initials: PH
authors.lastname: Hoeger
authors.forename: W
authors.initials: W
authors.lastname: Lenz
authors.forename: A
authors.initials: A
authors.lastname: Boutonnier
authors.forename: J M
authors.initials: JM
authors.lastname: Fournier
mesh_terms: D000293:Adolescent; D001427:Bacterial Toxins; D001434:Bacteriophage Typing; D002353:Carrier State / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D003876:Dermatitis, Atopic / Q000382:microbiology*; D004768:Enterotoxins / Q000096:biosynthesis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D009297:Nasal Mucosa / Q000382:microbiology; D015995:Prevalence; D012867:Skin / Q000382:microbiology*; D013207:Staphylococcal Skin Infections / Q000382:microbiology* / Q000635:transmission; D013211:Staphylococcus aureus / Q000145:classification / Q000254:growth & development* / Q000302:isolation & purification / Q000472:pathogenicity; D018089:Superantigens; D014774:Virulence
chemical_list: D001427:Bacterial Toxins; D004768:Enterotoxins; D018089:Superantigens; C030107:enterotoxin F, Staphylococcal