From the Departments of Dermatology.
Medical Microbiology, Medical University of Warsaw.
Dermatitis. 2020 May/Jun;31(3):215-222. doi: 10.1097/DER.0000000000000568.
Skin colonization by Staphylococcus aureus (SA) correlates with increased severity of atopic dermatitis (AD). The role of nasal SA carriage and coagulase-negative staphylococci (CNSs) in AD is unclear.
The aim of this study was to assess the influence of colonization of lesional/nonlesional skin and the anterior nares by SA and CNSs on AD severity in 63 adult patients.
Disease severity was assessed with SCORAD index. The total immunoglobulin E (IgE) concentration was determined using the enzyme-linked immunosorbent assay method. The prevalence and abundance of staphylococci were assessed with the combination of bacterial culture and mass spectrometry.
The prevalence values of SA within the skin (lesional/nonlesional) and anterior nares were 79.4%/61.9% and 69.8%, respectively (vs 5.6% and 13.9%, respectively in controls, P < 0.0001). The carriage of CNSs in all niches was associated with lower mean IgE concentration (1164.66 ± 1010.36 vs 1762.99 ± 1059.15, P < 0.0213; 1166.9 ± 1006.4 vs 2152.7 ± 759.2, P < 0.0063; 1022 ± 1100 vs 1925 ± 880.8, P < 0.0044, respectively). The abundance of SA correlated with the extent of skin lesions and total IgE (ρ = 0.42, P = 0.0007; ρ = 0.488, P < 0.0001; ρ = 0.312, P < 0.2; and ρ = 0.402, P = 0.0007; ρ = 0.403, P < 0.002; ρ = 0.287, P < 0.03, respectively).
Atopic dermatitis severity correlates with both cutaneous and nasal colonization by SA. Staphylococcus aureus seems to promote TH2-type response, whereas CNS probably limits this process. Preventive measures within the anterior nares should be considered for AD patients.
金黄色葡萄球菌（SA）在皮肤的定植与特应性皮炎（AD）的严重程度相关。鼻内 SA 定植和凝固酶阴性葡萄球菌（CNS）在 AD 中的作用尚不清楚。
本研究旨在评估 63 例成年患者皮损/非皮损皮肤和前鼻腔 SA 和 CNS 定植对 AD 严重程度的影响。
采用 SCORAD 指数评估疾病严重程度。采用酶联免疫吸附试验法测定总免疫球蛋白 E（IgE）浓度。采用细菌培养和质谱相结合的方法评估葡萄球菌的流行率和丰度。
皮肤（皮损/非皮损）和前鼻腔内 SA 的流行率值分别为 79.4%/61.9%和 69.8%（对照组分别为 5.6%和 13.9%，P<0.0001）。所有部位 CNS 的定植与平均 IgE 浓度较低相关（1164.66±1010.36 与 1762.99±1059.15，P<0.0213；1166.9±1006.4 与 2152.7±759.2，P<0.0063；1022±1100 与 1925±880.8，P<0.0044）。SA 的丰度与皮肤病变的严重程度和总 IgE 相关（ρ=0.42，P=0.0007；ρ=0.488，P<0.0001；ρ=0.312，P<0.2；ρ=0.402，P=0.0007；ρ=0.403，P<0.002；ρ=0.287，P<0.03）。
AD 的严重程度与 SA 的皮肤和鼻腔定植均相关。金黄色葡萄球菌似乎促进了 TH2 型反应，而 CNS 可能限制了这一过程。AD 患者应考虑在前鼻腔采取预防措施。
