title: Variation in Staphylococcus aureus Colonization in Relation to Disease Severity in Adults with Atopic Dermatitis during a Five-month Follow-up.
abstract: The aim of this study was to monitor Staphylococcus aureus colonization and disease severity in adults with atopic dermatitis (AD) during 5 months. Twenty-one patients attended 3 visits each for severity SCORing of Atopic Dermatitis (SCORAD) assessment, quantitative cultures from the skin and conventional cultures from the anterior nares, tonsils and perineum. S. aureus isolates were typed for strain identity with pulsed-field gel electrophoresis (PFGE). Seventy-one percent of patients were colonized with S. aureus on lesional skin at least once. Density (colony-forming units (CFU)/cm2) was higher on lesional skin than on non-lesional skin (p < 0.05). Density on lesional skin and number of colonized body sites were positively correlated with SCORAD (p = 0.0003 and p = 0.007, respectively). Persistent carriers of the same strain on lesional skin had higher mean SCORAD index than intermittent/non-carriers (36.3 and 17.1, respectively, p = 0.002). The results show a temporal correlation between several aspects of S. aureus colonization and disease severity in AD raising the question of the importance of this in pathogenesis and treatment.
authors.affiliation: Department of Dermatology and Venereology, Sahlgrenska University Hospital, SE-413 45 Göteborg, Sweden. mikael.alsterholm@vgregion.se.
authors.forename: Mikael
authors.initials: M
authors.lastname: Alsterholm
authors.forename: Louise
authors.initials: L
authors.lastname: Strömbeck
authors.forename: Annika
authors.initials: A
authors.lastname: Ljung
authors.forename: Nahid
authors.initials: N
authors.lastname: Karami
authors.forename: Johan
authors.initials: J
authors.lastname: Widjestam
authors.forename: Martin
authors.initials: M
authors.lastname: Gillstedt
authors.forename: Christina
authors.initials: C
authors.lastname: Åhren
authors.forename: Jan
authors.initials: J
authors.lastname: Faergemann
mesh_terms: D000328:Adult; D000368:Aged; D058491:Bacterial Load; D015169:Colony Count, Microbial; D003876:Dermatitis, Atopic / Q000175:diagnosis / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009666:Nose / Q000382:microbiology; D014066:Palatine Tonsil / Q000382:microbiology; D010502:Perineum / Q000382:microbiology; D012720:Severity of Illness Index; D012867:Skin / Q000382:microbiology*; D013207:Staphylococcal Skin Infections / Q000175:diagnosis / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000145:classification / Q000254:growth & development* / Q000302:isolation & purification; D013997:Time Factors