Global Antimicrobial Susceptibility Patterns of Staphylococcus aureus in Atopic Dermatitis: A Systematic Review and...

Area of Science:

• Dermatology
• Infectious Diseases
• Microbiology

Background:

• Atopic dermatitis patients frequently experience Staphylococcus aureus colonization and infection.
• Empirical antibiotic therapy is common, but data on S. aureus antimicrobial susceptibility in this population is geographically limited.
• Understanding antimicrobial resistance patterns is crucial for effective treatment of atopic dermatitis complications.

Purpose of the Study:

• To determine the antimicrobial susceptibility profiles of Staphylococcus aureus strains isolated from patients with atopic dermatitis.
• To analyze how susceptibility patterns differ based on the income level of the country of origin and the period of data collection.

Main Methods:

• A systematic review and meta-analysis of literature from inception to June 20, 2023, using major scientific databases.
• Inclusion criteria required studies reporting antibiotic susceptibility of S. aureus cutaneous isolates from atopic dermatitis patients.
• Data extraction followed Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines.

Main Results:

• Analysis of 61 studies encompassing 4091 S. aureus isolates revealed suboptimal antimicrobial susceptibility (≤85%) for methicillin, erythromycin, fusidic acid, and clindamycin.
• Most studies (75.4%) originated from high-income countries.
• Lower middle-income and upper middle-income countries showed significantly lower antimicrobial susceptibility to erythromycin, methicillin, and trimethoprim/sulfamethoxazole compared to high-income countries. Temporal trends showed no significant change in susceptibility patterns over time.

Conclusions:

• Antimicrobial susceptibility of S. aureus to several commonly used antibiotics, including beta-lactams, erythromycin, clindamycin, and fusidic acid, may be suboptimal for empirical use in atopic dermatitis patients.
• Significant geographic disparities in antimicrobial susceptibility patterns exist, particularly between high-income and middle-income countries.
• These findings highlight the need for updated guidelines for empirical antibiotic therapy in atopic dermatitis, considering regional resistance patterns.