Colonization With Methicillin Resistant and Methicillin Sensitive <i>Staphylococcus aureus</i> Subtypes in Patients With Atopic Dermatitis and Its Relationship With Severity of Eczema

Abstract

Background: Studies revealed that severity of atopic dermatitis correlates with colonization by S.aureus and the density of bacteria and antibiotic resistance is one of the factors in S.aureus recolonization. Objectives: We aimed to determine the pattern of colonization with different subtypes of S.aureus in patients with atopic dermatitis and its correlation with SCORAD (Scoring Atopic Dermatitis) index. Materials and Methods: We studied 114 sample cultures from normal skin, nose and active lesions of 38 patients with atopic dermatitis to detection of Staphylococcus aureus colonization and MRSA (methicilin resistance Staphylococcus aureus) subtypes with E test. The severity of the disease was identified by the SCORAD criteria. Logistic regression analysis was used for the evaluation of the coexistence between MRSA colonization and SCORAD index in these patients. Results: We studied 114 sample cultures from 38 children (73% boys, 27% girls) with atopic dermatitis. Mean age of the patients was 19 ± 22.7 months. Mean objective SCORAD was 37.8 + 16.4 (range: 15-80). Twelve patients (31.6%) had mild, 18 patients (47.4%) had moderate and 8 patients (21%) had severe SCORAD.\r\nSeventeen patients (44%) were colonized by S. aureus in the nose, 14 (36%) on skin lesions, and 8 (21%) on healthy skin. Among all the cultures, MSSA was noted in 26 (22%) and MRSA was noted in 13 (11%). There was a significant relationship between SCORAD index and colonization of nose and active lesions with Staphylococcus aureus (P value = 0.001). We found MRSA only in patients with moderate SCORAD. Conclusions: This study shows lower rate of S. aureus colonization in atopic dermatitis cases but similar rate of MRSA colonization in comparison with previous studies . A higher rate of MRSA colonization was found in patients with moderate SCORAD.