Alsterholm Mikael, Strömbeck Louise, Ljung Annika, Karami Nahid, Widjestam Johan, Gillstedt Martin, Åhren Christina, Faergemann Jan
Department of Dermatology and Venereology, Sahlgrenska University Hospital, SE-413 45 Göteborg, Sweden.
Acta Derm Venereol. 2017 Jul 6;97(7):802-807. doi: 10.2340/00015555-2667.
The aim of this study was to monitor Staphylococcus aureus colonization and disease severity in adults with atopic dermatitis (AD) during 5 months. Twenty-one patients attended 3 visits each for severity SCORing of Atopic Dermatitis (SCORAD) assessment, quantitative cultures from the skin and conventional cultures from the anterior nares, tonsils and perineum. S. aureus isolates were typed for strain identity with pulsed-field gel electrophoresis (PFGE). Seventy-one percent of patients were colonized with S. aureus on lesional skin at least once. Density (colony-forming units (CFU)/cm2) was higher on lesional skin than on non-lesional skin (p < 0.05). Density on lesional skin and number of colonized body sites were positively correlated with SCORAD (p = 0.0003 and p = 0.007, respectively). Persistent carriers of the same strain on lesional skin had higher mean SCORAD index than intermittent/non-carriers (36.3 and 17.1, respectively, p = 0.002). The results show a temporal correlation between several aspects of S. aureus colonization and disease severity in AD raising the question of the importance of this in pathogenesis and treatment.
本研究的目的是在5个月内监测成年特应性皮炎（AD）患者的金黄色葡萄球菌定植情况及疾病严重程度。21名患者各参加3次就诊，进行特应性皮炎严重程度评分（SCORAD）评估、皮肤定量培养以及前鼻孔、扁桃体和会阴的常规培养。采用脉冲场凝胶电泳（PFGE）对金黄色葡萄球菌分离株进行菌株鉴定分型。71%的患者皮损处至少有一次金黄色葡萄球菌定植。皮损处的密度（菌落形成单位（CFU）/cm²）高于非皮损处（p＜0.05）。皮损处的密度和定植的身体部位数量与SCORAD呈正相关（分别为p = 0.0003和p = 0.007）。皮损处同一菌株的持续携带者的平均SCORAD指数高于间歇性/非携带者（分别为36.3和17.1，p = 0.002）。结果显示，金黄色葡萄球菌定植的几个方面与AD疾病严重程度之间存在时间相关性，这引发了其在发病机制和治疗中的重要性问题。
