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Staphylococcus aureus colonization related to severity of hand eczema

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Abstract

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.

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References

  1. Mortz CG, Bindslev-Jensen C, Andersen KE (2014) Hand eczema in The Odense Adolescence Cohort Study on Atopic Diseases and Dermatitis (TOACS): prevalence, incidence and risk factors from adolescence to adulthood. Br J Dermatol 171(2):313–323

    Article  CAS  PubMed  Google Scholar 

  2. Montnemery P, Nihlen U, Lofdahl CG, Nyberg P, Svensson A (2005) Prevalence of hand eczema in an adult Swedish population and the relationship to risk occupation and smoking. Acta Derm Venereol 85(5):429–432

    Article  PubMed  Google Scholar 

  3. Coenraads PJ (2012) Hand eczema. N Engl J Med 367(19):1829–1837

    Article  CAS  PubMed  Google Scholar 

  4. Carlsson A, Ganemo A, Anderson CD, Meding B, Stenberg B, Svensson A (2011) Scoring of hand eczema: good agreement between patients and dermatological staff. Br J Dermatol 165(1):123–128

    Article  CAS  PubMed  Google Scholar 

  5. Gronhagen CM, Liden C, Bergstrom A, Kull I, Wahlgren CF, Meding B (2014) Prevalence and incidence of hand eczema in adolescence; report from BAMSE—a population-based birth cohort. Br J Dermatol 171(3):609–614

    Article  CAS  PubMed  Google Scholar 

  6. Haslund P, Bangsgaard N, Jarlov JO, Skov L, Skov R, Agner T (2009) Staphylococcus aureus and hand eczema severity. Br J Dermatol 161(4):772–777

    Article  CAS  PubMed  Google Scholar 

  7. Nilsson E, Henning C, Hjorleifsson ML (1986) Density of the microflora in hand eczema before and after topical treatment with a potent corticosteroid. J Am Acad Dermatol 15(2 Pt 1):192–197

    Article  CAS  PubMed  Google Scholar 

  8. Gong JQ, Lin L, Lin T, Hao F, Zeng FQ, Bi ZG, Yi D, Zhao B (2006) Skin colonization by Staphylococcus aureus in patients with eczema and atopic dermatitis and relevant combined topical therapy: a double-blind multicentre randomized controlled trial. Br J Dermatol 155(4):680–687

    Article  CAS  PubMed  Google Scholar 

  9. Park HY, Kim CR, Huh IS, Jung MY, Seo EY, Park JH, Lee DY, Yang JM (2013) Staphylococcus aureus colonization in acute and chronic skin lesions of patients with atopic dermatitis. Ann Dermatol 25(4):410–416

    Article  PubMed  PubMed Central  Google Scholar 

  10. Bibel DJ, Greenberg JH, Cook JL (1977) Staphylococcus aureus and the microbial ecology of atopic dermatitis. Can J Microbiol 23(8):1062–1068

    Article  CAS  PubMed  Google Scholar 

  11. David TJ, Cambridge GC (1986) Bacterial infection and atopic eczema. Arch Dis Child 61(1):20–23

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Leyden JJ, Marples RR, Kligman AM (1974) Staphylococcus aureus in the lesions of atopic dermatitis. Br J Dermatol 90(5):525–530

    Article  CAS  PubMed  Google Scholar 

  13. Paulson DS (1993) Evaluation of three microorganism recovery procedures used to determine handwash efficacy. Dairy, Food Environ Sanit 13(9):520–523

    Google Scholar 

  14. Matussek A, Taipalensuu J, Einemo IM, Tiefenthal M, Lofgren S (2007) Transmission of Staphylococcus aureus from maternity unit staff members to newborns disclosed through spa typing. Am J Infect Control 35(2):122–125

    Article  PubMed  Google Scholar 

  15. Melin S, Haeggman S, Olsson-Liljequist B, Sjolund M, Nilsson PA, Isaksson B, Lofgren S, Matussek A (2009) Epidemiological typing of methicillin-resistant Staphylococcus aureus (MRSA): spa typing versus pulsed-field gel electrophoresis. Scand J Infect Dis 41(6–7):433–439

    Article  CAS  PubMed  Google Scholar 

  16. Strommenger B, Braulke C, Heuck D, Schmidt C, Pasemann B, Nubel U, Witte W (2008) spa typing of Staphylococcus aureus as a frontline tool in epidemiological typing. J Clin Microbiol 46(2):574–581

    Article  CAS  PubMed  Google Scholar 

  17. Bryant PA, Venter D, Robins-Browne R, Curtis N (2004) Chips with everything: DNA microarrays in infectious diseases. Lancet Infect Dis 4(2):100–111

    Article  CAS  PubMed  Google Scholar 

  18. Nilsson P, Ripa T (2006) Staphylococcus aureus throat colonization is more frequent than colonization in the anterior nares. J Clin Microbiol 44(9):3334–3339

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Shopsin B, Gomez M, Montgomery SO, Smith DH, Waddington M, Dodge DE, Bost DA, Riehman M, Naidich S, Kreiswirth BN (1999) Evaluation of protein A gene polymorphic region DNA sequencing for typing of Staphylococcus aureus strains. J Clin Microbiol 37(11):3556–3563

    CAS  PubMed  PubMed Central  Google Scholar 

  20. Mernelius S, Lofgren S, Lindgren PE, Blomberg M, Olhager E, Gunnervik C, Lenrick R, Thrane MT, Isaksson B, Matussek A (2013) The effect of improved compliance with hygiene guidelines on transmission of Staphylococcus aureus to newborn infants: the Swedish Hygiene Intervention and Transmission of S. aureus study. Am J Infect Control 41(7):585–590

    Article  PubMed  Google Scholar 

  21. Kahl BC, Mellmann A, Deiwick S, Peters G, Harmsen D (2005) Variation of the polymorphic region X of the protein A gene during persistent airway infection of cystic fibrosis patients reflects two independent mechanisms of genetic change in Staphylococcus aureus. J Clin Microbiol 43(1):502–505

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Harmsen D, Claus H, Witte W, Rothganger J, Claus H, Turnwald D, Vogel U (2003) Typing of methicillin-resistant Staphylococcus aureus in a university hospital setting by using novel software for spa repeat determination and database management. J Clin Microbiol 41(12):5442–5448

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Monecke S, Slickers P, Ehricht R (2008) Assignment of Staphylococcus aureus isolates to clonal complexes based on microarray analysis and pattern recognition. FEMS Immunol Med Microbiol 53(2):237–251

    Article  CAS  PubMed  Google Scholar 

  24. Monecke S, Coombs G, Shore AC, Coleman DC, Akpaka P, Borg M, Chow H, Ip M, Jatzwauk L, Jonas D, Kadlec K, Kearns A, Laurent F, O’Brien FG, Pearson J, Ruppelt A, Schwarz S, Scicluna E, Slickers P, Tan HL, Weber S, Ehricht R (2011) A field guide to pandemic, epidemic and sporadic clones of methicillin-resistant Staphylococcus aureus. PLoS One 6(4):e17936

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Monecke S, Gavier-Widen D, Mattsson R, Rangstrup-Christensen L, Lazaris A, Coleman DC, Shore AC, Ehricht R (2013) Detection of mecC-positive Staphylococcus aureus (CC130-MRSA-XI) in diseased European hedgehogs (Erinaceus europaeus) in Sweden. PLoS One 8(6):e66166

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Ridom GmbH (2005) Ridom Spa Server, http://spa.ridom.de/. Accessed 9 Nov 2015

  27. Na SY, Roh JY, Kim JM, Tamang MD, Lee JR (2012) Analysis of colonization and genotyping of the exotoxins of Staphylococcus aureus in patients with atopic dermatitis. Ann Dermatol 24(4):413–419

    Article  PubMed  PubMed Central  Google Scholar 

  28. Ibler KS, Jemec GB, Diepgen TL, Gluud C, Lindschou Hansen J, Winkel P, Thomsen SF, Agner T (2012) Skin care education and individual counselling versus treatment as usual in healthcare workers with hand eczema: randomised clinical trial. BMJ 345:e7822

    Article  PubMed  PubMed Central  Google Scholar 

  29. Kluytmans JA, Mouton JW, Ijzerman EP, Vandenbroucke-Grauls CM, Maat AW, Wagenvoort JH, Verbrugh HA (1995) Nasal carriage of Staphylococcus aureus as a major risk factor for wound infections after cardiac surgery. J Infect Dis 171(1):216–219

    Article  CAS  PubMed  Google Scholar 

  30. von Eiff C, Becker K, Machka K, Stammer H, Peters G (2001) Nasal carriage as a source of Staphylococcus aureus bacteremia. Study Group. N Engl J Med 344(1):11–16

    Article  Google Scholar 

  31. Kluytmans JA, Mouton JW, VandenBergh MF, Manders MJ, Maat AP, Wagenvoort JH, Michel MF, Verbrugh HA (1996) Reduction of surgical-site infections in cardiothoracic surgery by elimination of nasal carriage of Staphylococcus aureus. Infect Control Hosp Epidemiol 17(12):780–785

    Article  CAS  PubMed  Google Scholar 

  32. Oshima Y, Ohji M, Inoue Y, Harada J, Motokura M, Saito Y, Emi K, Tano Y (1999) Methicillin-resistant Staphylococcus aureus infections after scleral buckling procedures for retinal detachments associated with atopic dermatitis. Ophthalmology 106(1):142–147

    Article  CAS  PubMed  Google Scholar 

  33. Elazhari M, Abu-Quatouseh LF, Elhabchi D, Zerouali K, Dersi N, Saile R, Timinouni M, Becker K (2012) Characterization of fusidic acid-resistant Staphylococcus aureus isolates in the community of Casablanca (Morocco). Int J Med Microbiol 302(2):96–100

    Article  CAS  PubMed  Google Scholar 

  34. Williamson DA, Monecke S, Heffernan H, Ritchie SR, Roberts SA, Upton A, Thomas MG, Fraser JD (2014) High usage of topical fusidic acid and rapid clonal expansion of fusidic acid-resistant Staphylococcus aureus: a cautionary tale. Clin Infect Dis 59(10):1451–1454

    Article  PubMed  Google Scholar 

  35. den Heijer CD, van Bijnen EM, Paget WJ, Stobberingh EE (2014) Fusidic acid resistance in Staphylococcus aureus nasal carriage strains in nine European countries. Future Microbiol 9(6):737–745

    Article  Google Scholar 

  36. Matussek A, Stark L, Dienus O, Aronsson J, Mernelius S, Lofgren S, Lindgren PE (2011) Analyzing multiclonality of Staphylococcus aureus in clinical diagnostics using spa-based denaturing gradient gel electrophoresis. J Clin Microbiol 49(10):3647–3648

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Stark L, Olofsson M, Lofgren S, Molstad S, Lindgren PE, Matussek A (2014) Prevalence and molecular epidemiology of Staphylococcus aureus in Swedish nursing homes—as revealed in the SHADES study. Epidemiol Infect 142(6):1310–1316

    Article  CAS  PubMed  Google Scholar 

  38. Pascolini C, Sinagra J, Pecetta S, Bordignon V, De Santis A, Cilli L, Cafiso V, Prignano G, Capitanio B, Passariello C, Stefani S, Cordiali-Fei P, Ensoli F (2011) Molecular and immunological characterization of Staphylococcus aureus in pediatric atopic dermatitis: implications for prophylaxis and clinical management. Clin Dev Immunol 2011:718708

    Article  PubMed  PubMed Central  Google Scholar 

  39. Silverberg JI, Hanifin J, Simpson EL (2013) Climatic factors are associated with childhood eczema prevalence in the United States. J Investig Dermatol 133(7):1752–1759

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Acknowledgments

We acknowledge Ann-Sofie Ekblom, Barbro Gunnarsson and Kicki Helander for technical assistance.

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Authors and Affiliations

  1. Microbiology Laboratory, Division of Medical Diagnostics, Region Jönköping County, Ryhov County Hospital, Försörjningsvägen 8, S - 551 85, Jönköping, Sweden

    S. Mernelius, E. Carlsson, S. Löfgren, P.-E. Lindgren & A. Matussek

  2. Allergy Centre and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden

    J. Henricson

  3. Division of Medical Microbiology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden

    P.-E. Lindgren

  4. Alere Technologies GmbH, Jena, Germany

    R. Ehricht & S. Monecke

  5. InfectoGnostics, Jena, Germany

    R. Ehricht & S. Monecke

  6. Department of Dermatology and Venereology, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden

    C. D. Anderson

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  1. S. Mernelius
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Corresponding author

Correspondence to S. Mernelius.

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Funding

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.

Ethical approval

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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Mernelius, S., Carlsson, E., Henricson, J. et al. Staphylococcus aureus colonization related to severity of hand eczema. Eur J Clin Microbiol Infect Dis 35, 1355–1361 (2016). https://doi.org/10.1007/s10096-016-2672-2

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  • DOI: https://doi.org/10.1007/s10096-016-2672-2

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