Staphylococcus aureus carriage in the anterior nares of close contacts of patients with atopic dermatitis.
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.
Chiu
Lai Shan
LS
Department of Medicine and Therapeutics, Ninth Floor, Clinical Science Building, Prince of Wales Hospital, Shatin, NT, Hong Kong SAR. monachiu@gmail.com
Chow
Viola Chi Ying
VC
Ling
Julia Mei Lun
JM
Hon
Kam Lun
KL
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
D037521:Virulence Factors