title: Confocal laser scanning microscopic observation of glycocalyx production by Staphylococcus aureus in skin lesions of bullous impetigo, atopic dermatitis and pemphigus foliaceus.
abstract: BACKGROUND
  Glycocalyx collapses during dehydration to produce electron-dense accretions. Confocal laser scanning microscopy (CLSM) may be used to visualize fully hydrated microbial biofilms.
  
  
  OBJECTIVE
  Using CLSM, to analyse glycocalyx production by Staphylococcus aureus cells in skin lesions of bullous impetigo, atopic dermatitis and pemphigus foliaceus. A second objective was to compare numbers of S. aureus cells in tissue sections prepared by different methods for routine light microscopy.
  
  
  METHODS
  S. aureus cells in skin lesions of impetigo, atopic dermatitis and pemphigus were stained with safranin, and positive staining with fluorescein isothiocyanate-conjugated concanavalin A was considered to indicate the presence of glycocalyx.
  
  
  RESULTS
  All S. aureus cells tested in skin lesions of impetigo, atopic dermatitis and pemphigus were covered with glycocalyx and formed microcolonies. The numbers of S. aureus cells in a routine light microscopy section were significantly lower than those in a frozen section that had not been dehydrated with ethanol.
  
  
  CONCLUSIONS
  S. aureus cells generally produce glycocalyx in skin lesions of bullous impetigo, atopic dermatitis and pemphigus foliaceus, which accounts for the difficulty of removing S. aureus cells from these skin lesions. The glycocalyx may collapse during dehydration and most of the S. aureus cells may be carried away during preparation of routine light microscope sections.
authors.affiliation: Department of Dermatology, Okayama University Graduate School of Medicine and Dentistry, Shikata-cho 2-5-1, Okayama 700-8558, Japan. akiyamah@cc.okayama-u.ac.jp
authors.forename: H
authors.initials: H
authors.lastname: Akiyama
authors.forename: T
authors.initials: T
authors.lastname: Hamada
authors.forename: W-K
authors.initials: WK
authors.lastname: Huh
authors.forename: O
authors.initials: O
authors.lastname: Yamasaki
authors.forename: T
authors.initials: T
authors.lastname: Oono
authors.forename: W
authors.initials: W
authors.lastname: Fujimoto
authors.forename: K
authors.initials: K
authors.lastname: Iwatsuki
mesh_terms: D019342:Acetic Acid / Q000494:pharmacology; D000293:Adolescent; D000328:Adult; D000368:Aged; D018441:Biofilms / Q000254:growth & development*; D002648:Child; D002675:Child, Preschool; D015169:Colony Count, Microbial; D003876:Dermatitis, Atopic / Q000382:microbiology*; D005260:Female; D005337:Fibrin; D005672:Fusidic Acid / Q000494:pharmacology; D019276:Glycocalyx / Q000378:metabolism*; D006801:Humans; D006851:Hydrochloric Acid / Q000494:pharmacology; D007169:Impetigo / Q000382:microbiology*; D008297:Male; D018613:Microscopy, Confocal / Q000379:methods*; D008875:Middle Aged; D010392:Pemphigus / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000187:drug effects / Q000502:physiology*
chemical_list: D005672:Fusidic Acid; D005337:Fibrin; D019342:Acetic Acid; D006851:Hydrochloric Acid