title: A systematic review and meta-analysis on Staphylococcus aureus carriage in psoriasis, acne and rosacea.
abstract: Staphylococcus aureus might amplify symptoms in chronic inflammatory skin diseases. This study evaluates skin and mucosal colonization with S. aureus in patients with psoriasis, acne and rosacea. A systematic literature search was conducted. Both odds ratios (OR) for colonization in patients versus controls and the prevalence of colonization in patients are reported. Fifteen articles about psoriasis and 13 about acne (12 having a control group) were included. No study in rosacea met our inclusion criteria. For psoriasis, one study out of three controlled studies showed increased skin colonization (OR 18.86; 95 % confidence interval [CI] 2.20-161.99). Three out of the five studies that reported on nasal colonization showed significant ORs varying from 1.73 (95 % CI 1.16-2.58) to 14.64 (95 % CI 2.82-75.95). For acne one of the three studies that evaluated skin colonization reported a significant OR of 4.16 (95 % CI 1.74-9.94). A relation between nasal colonization and acne was not found. Limitations in study design and low sample sizes should be taken into consideration when interpreting the results. Colonisation with S. aureus seems to be increased in patients with psoriasis. This bacterial species, known for its potential to induce long-lasting inflammation, might be involved in psoriasis pathogenesis. Information on acne is limited. Prospective controlled studies should further investigate the role of S. aureus in chronic inflammatory skin diseases.
authors.affiliation: Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands. j.totte@erasmusmc.nl.
authors.forename: J E E
authors.initials: JE
authors.lastname: Totté
authors.affiliation: Molecular and Cellular Life Sciences, Utrecht University, Utrecht, The Netherlands.
authors.forename: W T
authors.initials: WT
authors.lastname: van der Feltz
authors.affiliation: Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: L G M
authors.initials: LG
authors.lastname: Bode
authors.affiliation: bioMérieux, Scientific Office, La Balme Les Grottes, France.|Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: van Belkum
authors.affiliation: Department of Dermatology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: E J
authors.initials: EJ
authors.lastname: van Zuuren
authors.affiliation: Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
authors.forename: S G M A
authors.initials: SG
authors.lastname: Pasmans
mesh_terms: D000152:Acne Vulgaris / Q000150:complications / Q000382:microbiology*; D002353:Carrier State; D016022:Case-Control Studies; D006801:Humans; D009092:Mucous Membrane / Q000382:microbiology; D016017:Odds Ratio; D011565:Psoriasis / Q000150:complications / Q000382:microbiology*; D012393:Rosacea / Q000150:complications / Q000382:microbiology*; D012867:Skin / Q000382:microbiology; D013203:Staphylococcal Infections / Q000150:complications / Q000382:microbiology*; D013211:Staphylococcus aureus