title: Changes in Staphylococcus aureus density and lesion severity after topical application of povidone-iodine in cases of atopic dermatitis.
abstract: A case-control study was performed to examine the efficacy of 10% povidone-iodine solution applied to atopic dermatitis patients. The density of Staphylococcus aureus on the eczematous lesions and the lesion severity before and after the topical application of povidone-iodine were compared. We found a 10-100-fold decrease in the density of S. aureus after povidone-iodine treatment in patients colonizing S. aureus at an initial density of > 1000 CFU/10 cm2. Erythema and exudation also decreased after povidone-iodine treatment in patients colonizing S. aureus at an initial density of > 1000 CFU/10 cm2. The 10% povidone-iodine solution disinfected S. aureus cells when added immediately after the cells were mixed in human plasma; however, 10% povidone-iodine solution only reduced the density of S. aureus cells by 10-100-fold when S. aureus cells were harvested after a 24 h incubation in human plasma. Staphylococcus aureus cells harvested after 24 h incubation in human plasma were often surrounded by fibrin bundles and cells circumscribed by fibrin bundles could not be disinfected with 10% povidone-iodine solution. We suggest that S. aureus cells may produce biofilm-like structures in atopic dermatitis patients and that these structures may help S. aureus cells resist the 10% povidone-iodine treatment.
authors.affiliation: Department of Dermatology, Okayama University Medical School, Shikata-cho, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Akiyama
authors.forename: J
authors.initials: J
authors.lastname: Tada
authors.forename: J
authors.initials: J
authors.lastname: Toi
authors.forename: H
authors.initials: H
authors.lastname: Kanzaki
authors.forename: J
authors.initials: J
authors.lastname: Arata
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D016022:Case-Control Studies; D002648:Child; D003876:Dermatitis, Atopic / Q000188:drug therapy* / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D008854:Microscopy, Electron; D011206:Povidone-Iodine / Q000627:therapeutic use*; D013207:Staphylococcal Skin Infections / Q000188:drug therapy*; D013211:Staphylococcus aureus
chemical_list: D000891:Anti-Infective Agents, Local; D011206:Povidone-Iodine