Abstract
Carriage rates of Staphylococcus aureus on affected skin in atopic dermatitis (AD) are approximately 70%. Increasing disease severity during flares and overall disease severity correlate with increased burden of S. aureus. Treatment in AD therefore often targets S. aureus with topical and systemic antimicrobials.
ObjectivesTo determine whether antimicrobial sensitivities and genetic determinants of resistance differed in S. aureus isolates from the skin of children with AD and healthy child nasal carriers.
MethodsIn this case–control study, we compared S. aureus isolates from children with AD (n = 50) attending a hospital dermatology department against nasal carriage isolates from children without skin disease (n = 49) attending a hospital emergency department for noninfective conditions. Using whole genome sequencing we generated a phylogenetic framework for the isolates based on variation in the core genome, then compared antimicrobial resistance phenotypes and genotypes between disease groups.
ResultsStaphylococcus aureus from cases and controls had on average similar numbers of phenotypic resistances per isolate. Case isolates differed in their resistance patterns, with fusidic acid resistance (FusR) being significantly more frequent in AD (P = 0·009). The genetic basis of FusR also differentiated the populations, with chromosomal mutations in fusA predominating in AD (P = 0·049). Analysis revealed that FusR evolved multiple times and via multiple mechanism in the population. Carriage of plasmid‐derived qac genes, which have been associated with reduced susceptibility to antiseptics, was eight times more frequent in AD (P = 0·016).
ConclusionsThe results suggest that strong selective pressure drives the emergence and maintenance of specific resistances in AD.
Original language | English |
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Pages (from-to) | 951-958 |
Number of pages | 8 |
Journal | British Journal of Dermatology |
Volume | 179 |
Issue number | 4 |
Early online date | 24 Jul 2018 |
DOIs | |
Publication status | Published - 15 Oct 2018 |
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Matthew Holden
- School of Medicine - Director of Impact, Professor
- Biomedical Sciences Research Complex
- St Andrews Bioinformatics Unit
- Infection and Global Health Division
Person: Academic