Staphylococcus aureus resistance to topical antimicrobials in atopic dermatitis.
Topical antimicrobial drugs are indicated for limited superficial pyodermitis treatment, although they are largely used as self-prescribed medication for a variety of inflammatory dermatoses, including atopic dermatitis. Monitoring bacterial susceptibility to these drugs is difficult, given the paucity of laboratory standardization.
To evaluate the prevalence of Staphylococcus aureus topical antimicrobial drug resistance in atopic dermatitis patients.
We conducted a cross-sectional study of children and adults diagnosed with atopic dermatitis and S. aureus colonization. We used miscellaneous literature reported breakpoints to define S. aureus resistance to mupirocin, fusidic acid, gentamicin, neomycin and bacitracin.
A total of 91 patients were included and 100 S. aureus isolates were analyzed. All strains were methicillin-susceptible S. aureus. We found a low prevalence of mupirocin and fusidic acid resistance (1.1% and 5.9%, respectively), but high levels of neomycin and bacitracin resistance (42.6% and 100%, respectively). Fusidic acid resistance was associated with more severe atopic dermatitis, demonstrated by higher EASI scores (median 17.8 vs 5.7, p=.009). Our results also corroborate the literature on the absence of cross-resistance between the aminoglycosides neomycin and gentamicin.
Our data, in a southern Brazilian sample of AD patients, revealed a low prevalence of mupirocin and fusidic acid resistance of S. aureus atopic eczema colonizer strains. However, for neomycin and bacitracin, which are commonly used topical antimicrobial drugs in Brazil, high levels of resistance were identified. Further restrictions on the use of these antimicrobials seem necessary to keep resistance as low as possible.
Universidade Federal de Ciências da Saúde de Porto Alegre - UFCSPA - Porto Alegre (RS), Brazil.|Universidade Luterana do Brasil (ULBRA) - Canoas (RS), Brazil.
Giancarlo Rezende
GR
Bessa
Universidade Federal de Ciências da Saúde de Porto Alegre - UFCSPA - Porto Alegre (RS), Brazil.
Vanessa Petry
VP
Quinto
Universidade Federal de Ciências da Saúde de Porto Alegre - UFCSPA - Porto Alegre (RS), Brazil.
Daiane Corrêa
DC
Machado
Universidade Federal de Ciências da Saúde de Porto Alegre - UFCSPA - Porto Alegre (RS), Brazil.
Caroline
C
Lipnharski
Universidade Federal de Ciências da Saúde de Porto Alegre - UFCSPA - Porto Alegre (RS), Brazil.
Magda Blessmann
MB
Weber
Universidade Federal de Ciências da Saúde de Porto Alegre - UFCSPA - Porto Alegre (RS), Brazil.
Renan Rangel
RR
Bonamigo
Universidade Federal de Ciências da Saúde de Porto Alegre - UFCSPA - Porto Alegre (RS), Brazil.
Pedro Alves
PA
D'Azevedo
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001414:Bacitracin / Q000494:pharmacology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003876:Dermatitis, Atopic / Q000382:microbiology*; D052978:Disk Diffusion Antimicrobial Tests / Q000379:methods; D024881:Drug Resistance, Bacterial; D005260:Female; D005672:Fusidic Acid / Q000494:pharmacology; D005839:Gentamicins / Q000494:pharmacology; D006801:Humans; D007223:Infant; D008297:Male; D016712:Mupirocin / Q000494:pharmacology; D009355:Neomycin / Q000494:pharmacology; D013211:Staphylococcus aureus / Q000187:drug effects*; D055815:Young Adult
D000900:Anti-Bacterial Agents; D005839:Gentamicins; D001414:Bacitracin; D005672:Fusidic Acid; D016712:Mupirocin; D009355:Neomycin