Staphylococcal Skin Colonization in Children with Atopic Dermatitis: Prevalence, Persistence, and Transmission of Toxigenic and Nontoxigenic Strains

• Published in: The Journal of infectious diseases Vol. 165; no. 6; pp. 1064 - 1068
• Main Authors: Hoeger, Peter H., Lenz, Wolfgang, Boutonnier, Alain, Fournier, Jean-Michel
• Format: Journal Article
• Language: English
• Published: United States The University of Chicago Press 01-06-1992; University of Chicago Press
• Subjects: Adolescent; Atopic dermatitis; Bacterial colonization; Bacterial Toxins; Bacteriophage Typing; Bacteriophages; Carrier State - microbiology; Child; Child, Preschool; Dermatitis, Atopic - microbiology; Disease transmission; Enterotoxins - biosynthesis; Female; Follow-Up Studies; Humans; Infant; Major Articles; Male; Microbial colonization; Nasal Mucosa - microbiology; Prevalence; Skin; Skin - microbiology; Staphylococcal Skin Infections - microbiology; Staphylococcal Skin Infections - transmission; Staphylococcus; Staphylococcus aureus; Staphylococcus aureus - classification; Staphylococcus aureus - growth & development; Staphylococcus aureus - isolation & purification; Staphylococcus aureus - pathogenicity; Superantigens; Toxicity; Toxins; Virulence; Staphylococcus aureus
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/165.6.1064

Staphylococcal skin colonization is a common feature of atopic dermatitis (AD) in adults. Little is known about prevalence and persistence of staphylococci in children. Forty-one AD children (mean age, 70 months) and 41 age-matched controls were studied. S. aureus was isolated from 38 AD patients (93%;32% of controls, P < .001) and 37% ofAD patients (5% of controls, P < .001) harbored toxigenic (enterotoxins, toxic shock syndrome toxin) S. aureus strains. No individual biotype prevailed. On follow-up (mean interval, 9 months), 70% of S. aureus strains were reisolated. Nasal and cutaneous S. aureus strains were identical in 73% of AD patients (7% of controls, P < .001), reflecting increased self-contamination. Identical staphylococcal strains in AD children and their mothers were observed in 38% (S. aureus) and 16% (coagulase-negative strains; P < .001). The prevalence of staphylococcal colonization in AD children is comparable to that in adults. High rates of self-contamination, transmission to contacts, and prevalence of toxigenic strains in AD children may have clinical and epidemiologic implications.