Matiz Catalina, Tom Wynnis L, Eichenfield Lawrence F, Pong Alice, Friedlander Sheila Fallon
Division of Pediatric Dermatology, University of California, San Diego and Rady Children's Hospital, San Diego, California 92123, USA.
Pediatr Dermatol. 2011 Jan-Feb;28(1):6-11. doi: 10.1111/j.1525-1470.2010.01293.x. Epub 2010 Nov 11.
Given the increasing rate of community-acquired methicillin resistant Staphylococcus aureus skin infections in the population, such infections might be concurrently increasing in patients with atopic dermatitis. This study assessed current and prior rates of community-acquired methicillin resistant Staphylococcus aureus and methicillin-susceptible Staphylococcus aureus skin and soft tissue infections in children with atopic dermatitis compared to the general pediatric population. Other antibiotic sensitivity and resistance patterns, including clindamycin-inducible resistance, were also identified. Retrospective study of all skin and soft tissue isolates were positive for Staphylococcus aureus during two distinct 1-year periods, obtained by the outpatient services and the emergency department at Rady Children's Hospital, the major regional pediatric health center in San Diego, California. Of the Staphylococcus aureus isolates obtained from January to December 2000, none from atopic dermatitis patients were methicillin resistant Staphylococcus aureus, while 4.2% of those obtained from the general outpatient pediatric population showed methicillin resistance. In the period from June 2007 to May 2008, 11 of 78 isolates (14.1%) from children with atopic dermatitis were methicillin resistant Staphylococcus aureus. This was significantly lower than the rate of increase noted in the general pediatric population (658 of 1482, or 44.4%, in 2007/2008, p < 0.05). Clindamycin-inducible resistance was noted in 1.9% of the isolates in the general population; all six tested isolates from atopic patients lacked clindamycin-inducible resistance. In this study, children with atopic dermatitis had a much lower rate of community-acquired methicillin resistant Staphylococcus aureus infection compared to the general outpatient pediatric population. Clindamycin-inducible resistance was very low in both groups.
鉴于社区获得性耐甲氧西林金黄色葡萄球菌皮肤感染在人群中的发生率不断上升，此类感染在特应性皮炎患者中可能也在同时增加。本研究评估了与普通儿科人群相比，特应性皮炎患儿当前和既往社区获得性耐甲氧西林金黄色葡萄球菌以及甲氧西林敏感金黄色葡萄球菌皮肤和软组织感染的发生率。还确定了其他抗生素敏感性和耐药模式，包括克林霉素诱导性耐药。对加利福尼亚州圣地亚哥主要的地区儿科健康中心——拉迪儿童医院门诊服务部和急诊科在两个不同的1年期内获得的所有金黄色葡萄球菌皮肤和软组织分离株进行回顾性研究。在2000年1月至12月获得的金黄色葡萄球菌分离株中，特应性皮炎患者的分离株均无耐甲氧西林金黄色葡萄球菌，而普通儿科门诊人群的分离株中有4.2%显示耐甲氧西林。在2007年6月至2008年5月期间，78例特应性皮炎患儿的分离株中有11例（14.1%）为耐甲氧西林金黄色葡萄球菌。这显著低于普通儿科人群中观察到的增长率（2007/2008年为1482例中的658例，即44.4%，p<0.05）。普通人群中1.9%的分离株存在克林霉素诱导性耐药；所有6例来自特应性患者的检测分离株均无克林霉素诱导性耐药。在本研究中，与普通儿科门诊人群相比，特应性皮炎患儿社区获得性耐甲氧西林金黄色葡萄球菌感染的发生率要低得多。两组中克林霉素诱导性耐药均非常低。
