Staphylococcus aureus Colonization in Acute and Chronic Skin Lesions of Patients with Atopic Dermatitis

Abstract

Background: Staphylococcus aureus (SA) has peculiar abilities to colonize the skin in atopic dermatitis (AD) patients.

Objective: We sought to determine the colonization rates of SA in acute and chronic skin lesions of AD patients, to find any difference in colonization rates according to age and to find the influences of total immunoglobulin E (IgE) and eosinophil counts to the colonization of SA.

Methods: We evaluated the total IgE level and eosinophil counts, and cultured SA from the skin lesions of 687 AD patients (131 acute and 556 chronic skin lesions) and 247 control urticaria patients (July 2009 to November 2010; Samsung Medical Center Dermatology Clinic, Seoul, Korea).

Results: The SA colonization rates were 74%, 38% and 3% in acute, chronic skin lesions and control skin, respectively, and they were increased with age in AD patients. The colonization rate in chronic skin lesions was higher in the high IgE/eosinophilia groups as compared to the normal IgE/eosinophil groups.

Conclusion: The SA colonization rate was higher in AD patients and especially in acute lesions, and had a tendency to increase with age. As the colonization rates were only higher in the high IgE/eosinophilia groups of chronic skin lesions, we suggested that SA may invade the skin through barrier defects in acute skin lesions, but the colonization in chronic lesions may be orchestrated through many different factors.

Keywords: Atopic dermatitis; Colonization rate; Eosinophil counts; Serum total IgE; Staphylococcus aureus.

Fig. 1

Staphylococcus aureus colonization rates of atopic dermatitis patients according to serum total immunoglobulin (IgE) and eosinophila (Eo) statuses. We drew a plot for S. aureus colonization rates according to the combined level of two factors. Therefore, there are four categories among samples. Values of colonization rates are from colonization rates from (A) acute lesion and (B) chronic lesion combined with serum total IgE and eosinophil counts. In chronic lesions, we can see clearly decreasing patterns of colonization rates as the level of each factor is decreasing while there are weakly decreasing patterns in acute lesions.