Persistent skin colonization with Staphylococcus aureus in atopic dermatitis: relationship to clinical and immunological parameters
Article first published online: 11 APR 2005
Clinical & Experimental Allergy
Volume 35, Issue 4, pages 448–455, April 2005
How to Cite
Guzik, T. J., Bzowska, M., Kasprowicz, A., Czerniawska-Mysik, G., Wójcik, K., Szmyd, D., Adamek-Guzik, T. and Pryjma, J. (2005), Persistent skin colonization with Staphylococcus aureus in atopic dermatitis: relationship to clinical and immunological parameters. Clinical & Experimental Allergy, 35: 448–455. doi: 10.1111/j.1365-2222.2005.02210.x
- Issue published online: 11 APR 2005
- Article first published online: 11 APR 2005
- Submitted 17 June 2004; revised 17 November 2004; accepted 14 January 2005
- atopic dermatitis;
- immunoglobulin E;
- S. aureus;
Background Staphylococcus aureus has important implications for the pathogenesis of atopic dermatitis (AD). In some patients S. aureus can be eradicated from the skin during anti-inflammatory treatment, while in others bacterial colonization is persistent. Potential mechanisms and features of these two distinct groups of patients are not known.
Objective Accordingly, we studied relationships between the ability to eliminate S. aureus during an anti-inflammatory treatment and selected clinical and immunological features.
Methods Quantitative assessment of S. aureus on the skin, in nasal vestibule and throat, serum IgE levels, CD4/CD8 T-cell ratio, lymphocyte proliferation and phagocyte oxidative burst were determined during the exacerbation and after 4 and 12 weeks of the treatment using topical steroid and oral antihistamine in 34 patients with AD.
Results S. aureus was found on the skin of all 34 patients during exacerbation. Disease severity scoring of atopic dermatitis (SCORAD) correlated with the density of bacteria. Treatment with oral antihistamine and topical steroid resulted in a significant alleviation of symptoms, which correlated with the elimination of S. aureus from the skin in 70% of patients. In the remaining 30% of patients, dense (more than 1010/cm2) S. aureus skin colonization, persisted despite the treatment. Patients with persistent S. aureus presented with higher serum IgE levels, lower lymphocyte proliferation in response to staphylococcal enterotoxin B, phytohaemagluttinin and anti-CD3. Persistence of S. aureus was more common in men.
Conclusions Patients with AD differ in the ability to clear S. aureus from the skin during anti-inflammatory treatment, which appears to be related to the abnormalities in immunological parameters. Local antibiotic therapy should be considered only in patients with persistent S. aureus colonization.