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[The relationship between Staphylococcus aureus and atopic keratoconjunctivitis].
Kyoko Tabuchi1, Noriko Inada, Jun Shoji
1Department of Ophthalmology, Nihon University School of Medicine, Tokyo, Japan.
Nippon Ganka Gakkai Zasshi
|September 14, 2004
Summary
Staphylococcus aureus is a key factor in worsening vernal and atopic keratoconjunctivitis, especially when complicated by atopic dermatitis. Evaluating bacterial cultures and specific IgE in tears is crucial for managing these conditions.
Area of Science:
- Ophthalmology
- Microbiology
- Immunology
Context:
- Vernal keratoconjunctivitis (VKC) and atopic keratoconjunctivitis (AKC) are chronic allergic eye diseases.
- Atopic dermatitis (AD) frequently co-occurs with VKC and AKC, complicating their management.
- The role of bacterial infections, particularly Staphylococcus aureus, in exacerbating these conditions is not fully understood.
Purpose:
- To investigate the prevalence and role of Staphylococcus aureus in patients with VKC and AKC.
- To determine the association between Staphylococcus aureus and specific IgE antibodies to staphylococcal enterotoxins (SEA and SEB) in patients with co-existing atopic dermatitis.
- To evaluate the diagnostic utility of conjunctival sac cultures and tear-specific IgE levels.
Summary:
- Bacteriological cultures from the conjunctival sac revealed Staphylococcus aureus in 77.8% of patients with acute exacerbated VKC and AKC.
- Serum IgE antibodies against staphylococcal enterotoxins A (SEA) and B (SEB) were significantly higher in patients with co-existing atopic dermatitis compared to controls.
- Tear-specific IgE antibodies to SEA and SEB were detected in most patients with positive conjunctival cultures, suggesting a localized immune response.
Impact:
- Staphylococcus aureus should be considered a significant exacerbating factor in VKC and AKC, particularly in patients with atopic dermatitis.
- Clinical management should include both microbiological assessment of the conjunctiva and evaluation of tear-specific IgE levels.
- This study highlights the importance of a comprehensive approach to managing allergic eye diseases complicated by bacterial infections and atopic conditions.