Premium
Prevalence of community‐acquired methicillin‐resistant S taphylococcus aureus and antibiotic resistance in patients with atopic dermatitis in P orto A legre, Brazil
Author(s) -
Petry Vanessa,
Lipnharski Caroline,
Bessa Giancarlo R.,
Silveira Vera B.,
Weber Magda B.,
Bonamigo Renan R.,
d'Azevedo Pedro A.
Publication year - 2014
Publication title -
international journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 93
eISSN - 1365-4632
pISSN - 0011-9059
DOI - 10.1111/ijd.12020
Subject(s) - medicine , atopic dermatitis , staphylococcus aureus , methicillin resistant staphylococcus aureus , anterior nares , antibiotics , atopy , antimicrobial , eczema area and severity index , population , dermatology , antibiotic resistance , allergy , immunology , microbiology and biotechnology , bacteria , genetics , environmental health , biology
Background Atopic dermatitis ( AD ) is a skin manifestation of atopy caused by hyperreactivity to various antigens. Studies have shown that 60–100% of patients with this condition present with colonization by S taphylococcus aureus . Given increasing rates of antimicrobial resistance, the sensitivity to antimicrobials of S . aureus colonizing atopic patients has been investigated. Cross‐sectional studies worldwide suggest that the prevalence of methicillin‐resistant S . aureus infection ( MRSA ) in the AD population varies from 0% to 30.8%. Objectives The objectives of this study were to determinate the prevalence of S . aureus and MRSA in patients with AD in two dermatologic centers in Porto A legre, B razil. Methods A total of 91 patients with AD attending two dermatologic centers in P orto A legre were enrolled in this study from D ecember 2009 to J uly 2011. Two skin swabs were taken from each patient, one from the nares and the other from a non‐infected eczematous skin lesion. The swabs were sent to the laboratory, where standard procedures to isolate bacteria and identify S . aureus , antimicrobial resistance, and sensitivity patterns were carried out. The severity of AD was defined using the Eczema Area and Severity Index ( EASI ). Results Of the 91 patients sampled, 67 (73.6%) patients were found to be positive for S . aureus colonization. Nasal swabs were positive in 55 (60.4%) patients, lesional swabs in 44 (48.4%) patients, and both lesional and nasal swabs were positive in 32 (35.2%) patients. Patients with positive swabs had a higher mean ± standard deviation EASI score [mean (9.1 ± 8.8)] compared with patients with negative swabs (3.9 ± 3.6) ( P = 0.002). None of the 91 patients showed any evidence of MRSA infection. Overall, nearly 32% of the S . aureus isolated from nasal swabs and 36.40% of the S . aureus isolated from lesional swabs was resistant to erythromycin. Conclusions The results of this study confirm a high rate of S . aureus colonization in pediatric patients with AD and indicate a relevant association between colonization and high EASI score. No MRSA was found in cultures from this sample of patients in southern B razil. Nearly one‐third of isolates were identified as resistant to erythromycin, an antibiotic that is commonly used in pediatric patients.