Methicillin-resistant Staphylococcus aureus (MRSA) is an important pathogen in erythrodermic cutaneous T-cell lymphoma (CTCL) patients
Erythroderma can occur in cutaneous T-cell lymphoma (CTCL). Staphylococcus aureus ( S. aureus ) prevalence is increased in CTCL patients and contributes to CTCL disease flares. Our primary aim was to describe S. aureus infections, including resistance patterns and the antibiotic treatment regimens u...
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Published in | Archives of Dermatological Research Vol. 312; no. 4; pp. 283 - 288 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
Published |
Berlin/Heidelberg
Springer Berlin Heidelberg
01.05.2020
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Subjects | |
Online Access | Get full text |
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Summary: | Erythroderma can occur in cutaneous T-cell lymphoma (CTCL).
Staphylococcus aureus
(
S. aureus
) prevalence is increased in CTCL patients and contributes to CTCL disease flares. Our primary aim was to describe
S. aureus
infections, including resistance patterns and the antibiotic treatment regimens used, in erythrodermic CTCL patients. This was a retrospective chart review of erythrodermic CTCL patients who had
S. aureus
infection or colonization and were treated at the UT MD Anderson Cancer Center’s Melanoma Skin Center between 2012 and 2016. Twenty-six erythrodermic CTCL patients had 50 documented
S. aureus
colonization or infection events. Patients had an improvement in body surface area (BSA) or modified Severity Weighted Assessment Tool (mSWAT) in 53% events treated for
S. aureus
. Seventeen of the 50 (34%) events were due to methicillin-resistant
S. aureus
(MRSA). One-third (33%) of MRSA events were initially treated with dicloxacillin. The MRSA isolates were sensitive to trimethoprim–sulfamethoxazole (92%) and doxycycline (88%). Patients treated in the outpatient setting (OR 0.073; 95% CI 0.008–0.627;
p
= 0.017) and patients with a previous history of topical anti-
S. aureus
decolonization treatments before
S. aureus
event as stand-alone (OR 0.125; 95% CI 0.018–0.887;
p
= 0.038) or in combination treatment with systemic antibiotics (OR 0.094; 95% CI 0.009–0.944;
p
= 0.045) were less likely to see improvement in BSA or mSWAT from
S. aureus
treatment. Treatment of
S. aureus
improved CTCL skin score in a high number of erythrodermic patients. The MRSA prevalence was high in erythrodermic CTCL patients. Clinicians should consider using empiric MRSA antibiotic coverage for these patients. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 0340-3696 1432-069X |
DOI: | 10.1007/s00403-019-02015-7 |