title: Staphylococcus aureus carriage in the anterior nares of close contacts of patients with atopic dermatitis.
abstract: OBJECTIVE
  To study the prevalence of Staphylococcus aureus colonization in close contacts of patients with atopic dermatitis (AD) and the influence on AD severity.
  
  
  METHODS
  Prospective case-control study.
  
  
  METHODS
  Pediatric dermatology clinic in a Hong Kong university hospital. Patients We recruited 211 subjects prospectively, including 50 AD patients, 50 non-AD control subjects, 60 close contacts of AD patients, and 51 close contacts of controls. Intervention Nasal swabs and skin swabs were taken. Severity of AD was assessed using the SCORAD (Scoring Atopic Dermatitis) index.
  
  
  METHODS
  The prevalence of S aureus colonization in the close contacts of AD patients was compared with that of the close contacts of non-AD controls. Between-group differences were assessed, where appropriate, by unpaired t test or Pearson chi(2) test. Multivariate logistic regression using the forward stepwise method was performed to identify independent predictors of severe AD. A probability value of P < .05 was considered statistically significant.
  
  
  RESULTS
  Significantly more nasal carriers of S aureus were found among the close contacts of AD patients (14 of 60 [23%]) than among the close contacts of non-AD controls (4 of 51 [8%] [P = .03]). The difference was still significant after the exclusion of the AD patients' close contacts who also had AD (24% vs 8% [P = .03]). By multivariate analysis, only skin colonization of S aureus was independently associated with severe AD (odds ratio, 17.0; 95% confidence interval, 1.60-181.1 [P = .02]).
  
  
  CONCLUSIONS
  Anterior nares of close contacts of AD patients are reservoirs of S aureus. The presence of S aureus carriers among close contacts does not predict AD severity. Skin colonization is associated with severe AD.
authors.affiliation: Department of Medicine and Therapeutics, Ninth Floor, Clinical Science Building, Prince of Wales Hospital, Shatin, NT, Hong Kong SAR. monachiu@gmail.com
authors.forename: Lai Shan
authors.initials: LS
authors.lastname: Chiu
authors.forename: Viola Chi Ying
authors.initials: VC
authors.lastname: Chow
authors.forename: Julia Mei Lun
authors.initials: JM
authors.lastname: Ling
authors.forename: Kam Lun
authors.initials: KL
authors.lastname: Hon
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015169:Colony Count, Microbial; D003876:Dermatitis, Atopic / Q000150:complications / Q000453:epidemiology / Q000382:microbiology*; D005260:Female; D005500:Follow-Up Studies; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008297:Male; D009296:Nasal Cavity / Q000382:microbiology*; D009894:Opportunistic Infections / Q000150:complications / Q000382:microbiology* / Q000635:transmission; D015995:Prevalence; D011446:Prospective Studies; D012720:Severity of Illness Index; D012867:Skin / Q000382:microbiology*; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology* / Q000635:transmission; D013211:Staphylococcus aureus / Q000302:isolation & purification* / Q000472:pathogenicity; D037521:Virulence Factors; D055815:Young Adult
chemical_list: D037521:Virulence Factors