Department of Pathophysiology and Transplantation, Università degli Studi di Milano, I.R.C.C.S. Foundation, Cà Granda Ospedale Maggiore Policlinico, Milan, Italy.
Int J Dermatol. 2018 Oct;57(10):1218-1220. doi: 10.1111/ijd.14123. Epub 2018 Jul 5.
Skin bacterial colonizations and superinfections are well-known complications of scabies, in particular, in tropical and subtropical countries. However, only very rare studies on skin bacterial colonizations and superinfections have been carried out in immunocompetent patients with scabies living in Western countries.
Eighty-nine Caucasian adult immunocompetent patients with scabies living in Milan, Italy, were subjected to bacteriologic examinations of the skin. Clinical diagnosis of scabies was confirmed in all patients by means of microscopic examinations: they were considered positive when adults or eggs or feces of Sarcoptes scabiei var. hominis were visible. In all patients, six skin swabs (three for aerobic and three for anaerobic bacteria) were taken in three different areas before the beginning of the treatment.
No clinical manifestations of pyoderma were observed. Bacteriologic examinations were positive in 5/89 patients (5.6%). Bacteriologic cultures were positive for Staphylococcus aureus in all five patients; in one patient, they were also positive for Escherichia coli. No growth of anaerobic bacteria was recorded.
According to the results of this study, skin bacterial colonizations and superinfections in immunocompetent adult patients with scabies living in Milan are uncommon. Bacteriologic examinations may therefore be considered as an unnecessary routine procedure.
皮肤细菌定植和继发感染是疥疮的已知并发症，特别是在热带和亚热带国家。然而，在西方免疫功能正常的疥疮患者中，仅有非常罕见的关于皮肤细菌定植和继发感染的研究。
89 名居住在意大利米兰的白种人免疫功能正常的疥疮成年患者接受了皮肤细菌学检查。所有患者均通过显微镜检查确诊为疥疮：当可见人疥螨的成虫、虫卵或粪便时，即被认为是阳性。在所有患者中，在开始治疗前，在三个不同部位采集了 6 个皮肤拭子（3 个用于需氧菌，3 个用于厌氧菌）。
未观察到脓疱病的临床表现。5/89 例（5.6%）患者的细菌学检查呈阳性。所有 5 例患者的细菌培养均为金黄色葡萄球菌阳性，其中 1 例也为大肠埃希菌阳性。未记录到厌氧菌生长。
根据这项研究的结果，居住在米兰的免疫功能正常的成年疥疮患者中皮肤细菌定植和继发感染并不常见。因此，细菌学检查可以被视为一种不必要的常规程序。
