Staphylococcus aureus colonization related to severity of hand eczema

• Published in: European journal of clinical microbiology & infectious diseases Vol. 35; no. 8; pp. 1355 - 1361
• Main Authors: Mernelius, S., Carlsson, E., Henricson, J., Löfgren, S., Lindgren, P.-E., Ehricht, R., Monecke, S., Matussek, A., Anderson, C. D.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.08.2016; Springer Nature B.V
• Subjects: Anti-Bacterial Agents - pharmacology; Biomedical and Life Sciences; Biomedicine; Case-Control Studies; Colonization; Deoxyribonucleic acid; DNA; Drug Resistance, Bacterial; Eczema; Eczema - complications; Eczema - microbiology; Epidemiology; Female; Hands; Humans; Internal Medicine; Male; Medical Microbiology; Molecular Typing; Original Article; Patients; Skin diseases; Staphylococcal Infections - complications; Staphylococcal Infections - microbiology; Staphylococcal Skin Infections - complications; Staphylococcal Skin Infections - microbiology; Staphylococcus aureus; Staphylococcus aureus - drug effects; Staphylococcus aureus - genetics; Staphylococcus aureus - isolation & purification; Sweden; Germany; Colonization Rate; Minimum Span Tree; Fusidic Acid; Atopic Dermatitis; Genetic Makeup
• DOI: 10.1007/s10096-016-2672-2
• ISSN: 0934-9723; 1435-4373

Knowledge on Staphylococcus aureus colonization rates and epidemiology in hand eczema is limited. The aim of this study was to clarify some of these issues. Samples were collected by the “glove juice” method from the hands of 59 patients with chronic hand eczema and 24 healthy individuals. Swab samples were taken from anterior nares and throat from 43 of the 59 patients and all healthy individuals. S. aureus were spa typed and analysed by DNA-microarray-based genotyping. The extent of the eczema was evaluated by the hand eczema extent score (HEES). The colonization rate was higher on the hands of hand eczema patients (69 %) compared to healthy individuals (21 %, p  < 0.001). This was also seen for bacterial density ( p  = 0.002). Patients with severe hand eczema (HEES ≥ 13) had a significantly higher S. aureus density on their hands compared to those with milder eczema (HEES = 1 to 12, p  = 0.004). There was no difference between patients and healthy individuals regarding colonization rates in anterior nares or throat. spa typing and DNA-microarray-based genotyping indicated certain types more prone to colonize eczematous skin. Simultaneous colonization, in one individual, with S. aureus of different types, was identified in 60–85 % of the study subjects. The colonization rate and density indicate a need for effective treatment of eczema and may have an impact on infection control in healthcare.