Staphylococcus aureus colonization related to severity of hand eczema
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Knowledge on Staphylococcus aureus colonization rates and epidemiology in hand eczema is limited. The aim of this study was to clarify some of these issues. Samples were collected by the “glove juice” method from the hands of 59 patients with chronic hand eczema and 24 healthy individuals. Swab samples were taken from anterior nares and throat from 43 of the 59 patients and all healthy individuals. S. aureus were spa typed and analysed by DNA-microarray-based genotyping. The extent of the eczema was evaluated by the hand eczema extent score (HEES). The colonization rate was higher on the hands of hand eczema patients (69 %) compared to healthy individuals (21 %, p < 0.001). This was also seen for bacterial density (p = 0.002). Patients with severe hand eczema (HEES ≥ 13) had a significantly higher S. aureus density on their hands compared to those with milder eczema (HEES = 1 to 12, p = 0.004). There was no difference between patients and healthy individuals regarding colonization rates in anterior nares or throat. spa typing and DNA-microarray-based genotyping indicated certain types more prone to colonize eczematous skin. Simultaneous colonization, in one individual, with S. aureus of different types, was identified in 60–85 % of the study subjects. The colonization rate and density indicate a need for effective treatment of eczema and may have an impact on infection control in healthcare.
KeywordsAtopic Dermatitis Colonization Rate Minimum Span Tree Genetic Makeup Fusidic Acid
We acknowledge Ann-Sofie Ekblom, Barbro Gunnarsson and Kicki Helander for technical assistance.
Compliance with ethical standards
This study was in part financed by the Medical Research Council of Southeast Sweden, Futurum – the Academy of Healthcare, County Council, Jönköping and Medeca Pharma AB, Uppsala. The sponsors had no influence on study design or collection, analysis and interpretation of data or the writing and submission of the article.
Conflict of interest
S. Monecke and R. Ehricht are employees at Alere Technologies GmbH, where the DNA-microarray-based genotyping was performed. The other authors declare that they have no conflict of interest.
All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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