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Exploring Staphylococcus epidermidis in atopic eczema: friend or foe?
K L Hon1, Y C K Tsang1, N H Pong1
1Department of Paediatrics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China.
Clinical and Experimental Dermatology
|July 16, 2016
Summary
Staphylococcus epidermidis (SE) appears to displace Staphylococcus aureus (SA) on severely affected skin in children with atopic dermatitis (AD). SE colonization is linked to increased disease severity and reduced treatment frequency.
Area of Science:
- Dermatology
- Microbiology
- Pediatrics
Background:
- Staphylococcus aureus (SA) colonization is a known factor in childhood atopic dermatitis (AD) pathophysiology.
- The role of Staphylococcus epidermidis (SE) in AD remains unclear.
Purpose of the Study:
- To investigate if SE co-infects with SA in AD patients.
- To determine the association between SE and disease severity in childhood AD.
Main Methods:
- Skin swabs were collected from the most affected and flexural areas of 100 pediatric AD patients.
- Bacteriological cultures were analyzed for SA and SE presence.
- Associations with SCORing Atopic Dermatitis (SCORAD), skin hydration, transepidermal water loss (TEWL), and quality of life (QoL) were evaluated.
Main Results:
- SE was detected in 28% of severe sites and 32% of flexural sites; SA was present in 69% and 55%, respectively.
- SE inversely correlated with SA presence in severely affected skin (aOR=0.42) and decreased emollient/antihistamine use.
- SE presence in severe skin sites was positively associated with higher objective SCORAD scores (aOR=1.04).
Conclusions:
- Staphylococcus epidermidis (SE) may play a significant role beyond being a commensal in skin microbiota.
- SE appears to amensalistically displace Staphylococcus aureus (SA) on the skin.
- SE colonization is associated with increased disease severity in childhood atopic dermatitis.
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