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Journal ArticleDOI

Microbiology of infected atopic dermatitis

01 Nov 1996-International Journal of Dermatology (Blackwell Publishing Ltd)-Vol. 35, Iss: 11, pp 791-793
TL;DR: The objectives of the study were to establish the aerobic and anaerobic microbiology of secondarily infected AD and to investigate the mechanisms leading to bacterial infections in atopic dermatitis.
Abstract: Background. Bacterial infections occur frequently in lesions of atopic dermatitis (AD). The objectives of the study were to establish the aerobic and anaerobic microbiology of secondarily infected AD. Methods. A retrospective review was carried out of clinical and microbiology laboratory records and of data obtained from patients with secondarily infected AD lesions, whose specimens of infected sites were processed for the presence of aerobic and anaerobic bacteria. Results. Bacterial growth was noted in 41 specimens. Aerobic or facultative anaerobic bacteria only were present in 15 patients (36%), anaerobic bacteria only in eight (20%), and mixed anaerobic-aerobic flora was present in 18 (44%). Seventy- two isolates were recovered (1.8 per specimen), 34 aerobic or facultative bacteria, 35 strict anaerobes, and three Candida sp. The predominant aerobic and facultative bacteria were Staphylococcus aureus (12 isolates). Group A beta hemolytic streptococcus in five isolates, and Escherichia coli in four. The predominant anaerobes were peptostreptococcus spp. (13 isolates), pigmented Prevotella and Porphyromonas spp. in eight, and Fusobacterium spp. in four isolates. Single bacterial isolates were recovered in 14 patients (34%), seven of which were S. aureus. Twenty-one of the organisms isolated from 16 patients (39%) produced the enzyme beta-lactamase. Organisms that resided in the mucous membranes close to the lesions predominated in these infections. Enteric gram-negative rods and bacteroides fragilis group predominated in lesions on legs and buttocks. Group A beta-hemolytic streptococci, pigmented Prevotella, and Porphyromonas and Fusobacterium spp. were most frequently recovered in lesions of the finger, scalp, face, and neck. Conclusions. The polymicrobial etiology of secondarily infected AD lesions and the association of bacterial flora with the anatomic site of the lesions are demonstrated.
Citations
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Journal ArticleDOI
TL;DR: This review focuses on the clinical, mycologic, and immunologic aspects of the various skin diseases associated with Malassezia and highlights the importance of individual MalasseZia species in the different dermatologic disorders related to these yeasts.
Abstract: The yeasts of the genus Malassezia have been associated with a number of diseases affecting the human skin, such as pityriasis versicolor, Malassezia (Pityrosporum) folliculitis, seborrheic dermatitis and dandruff, atopic dermatitis, psoriasis, and--less commonly--with other dermatologic disorders such as confluent and reticulated papillomatosis, onychomycosis, and transient acantholytic dermatosis. Although Malassezia yeasts are a part of the normal microflora, under certain conditions they can cause superficial skin infection. The study of the clinical role of Malassezia species has been surrounded by controversy because of their fastidious nature in vitro, and relative difficulty in isolation, cultivation, and identification. Many studies have been published in the past few years after the taxonomic revision carried out in 1996 in which 7 species were recognized. Two new species have been recently described, one of which has been isolated from patients with atopic dermatitis. This review focuses on the clinical, mycologic, and immunologic aspects of the various skin diseases associated with Malassezia. It also highlights the importance of individual Malassezia species in the different dermatologic disorders related to these yeasts.

455 citations

Journal ArticleDOI
TL;DR: Atopic dermatitis is a chronic, itching, inflammatory skin disease which is associated with asthma and/or hay fever and a familial occurrence of these conditions and Genetic factors are important in the development of AD, but the exact hereditary pathway is still unknown.
Abstract: Atopic dermatitis (AD) is a chronic, itching, inflammatory skin disease which is associated with asthma and/or hay fever and a familial occurrence of these conditions. Genetic factors are important in the development of AD, but the exact hereditary pathway is still unknown. Dry skin and the weakened barrier function in patients with AD is very important for the patient's reactions to irritants and other external trigger factors including microorganisms. The standard treatments are topical corticosteroids, topical immunomodulating agents, and emollients. If AD cannot be controlled by this type of treatment, systemic immunomodulating agents may be used. UVB, UVA, or psoralen-UVA may also be used for widespread severe lesions. However, some patients do not respond to these standard treatment, and then it is important to consider the role of microorganisms, house dust mites or food. The role of the Malassezia yeasts in AD, especially AD located to the head and neck region, is now documented in several papers. There are also several papers indicating the role of Candida as an aggravating factor in AD. Patients with AD also develop chronic dermatophyte infections more easily, and patients with AD and chronic dermatophyte infections may show improvement in their AD when treated with antifungal drugs.

167 citations


Cites background from "Microbiology of infected atopic der..."

  • ...Staphylococcus aureus can be cultured from both involved and uninvolved skin in 85 to 90% of patients with AD (1, 21, 40, 44, 95, 110)....

    [...]

Journal ArticleDOI
TL;DR: This review summarises a series of studies of the microbiology of several of these infections: scabies, psoriasis, poison ivy, atopic dermatitis, eczema herpeticum and kerion, which highlight the polymicrobial aerobic-anaerobic microbiologists of secondarily infected skin lesions.
Abstract: Secondary bacterial infection in skin lesions is a common problem. This review summarises a series of studies of the microbiology of several of these infections: scabies, psoriasis, poison ivy, atopic dermatitis, eczema herpeticum and kerion. Staphylococcus aureus and group A β-haemolytic streptococci were the most prevalent aerobes and were isolated from all body sites. In contrast, organisms that reside in the mucous membranes close to the lesions predominated in infections next to these membranes. In this fashion, enteric gram-negative bacilli and Bacteroides spp. were found most often in buttock and leg lesions. The probable sources of these organisms are the rectum and vagina, where they normally reside. Group A β-haemolytic streptococci, pigmented Prevotella and Porphyromonas spp. and Fusobacterium spp. were most commonly found in lesions of the head, face, neck and fingers. These organisms probably reached these sites from the oral cavity, where they are part of the normal flora. This review highlights the polymicrobial aerobic–anaerobic microbiology of secondarily infected skin lesions.

119 citations


Cites background from "Microbiology of infected atopic der..."

  • ...The skin lesions that can be secondarily infected with bacteria are scabies [1], psoriasis [2], poison ivy [3], atopic dermatitis [4], eczema herpeticum [5] and kerion [6]....

    [...]

  • ...Bacterial growth was noted in 41 specimens from patients with secondarily infected atopic dermatitis lesions [4] (Table 1)....

    [...]

Journal ArticleDOI
TL;DR: The objectives of this study were to evaluate the microbiology of the skin of AD patients for staphylococci, the frequency and density of each species, and their susceptibility to antimicrobial drugs.
Abstract: Background Bacterial infections occur frequently on the skin of atopic dermatitis (AD) patients. The objectives of this study were to evaluate the microbiology of the skin of AD patients for staphylococci, the frequency and density of each species, and their susceptibility to antimicrobial drugs. Methods To study the staphylococci present on the skin of 21 AD outpatients and of 12 healthy subjects (HS), cutaneous organisms were obtained using the contact-plate method. ResultsStaphylococcus aureus was isolated in 85.7% of AD patients (mild type, 77.8%; moderate type, 87.8%; and severe type, 100%) and in 25% of HS, while Staphylococcus epidermidis was isolated in 83.3% of HS and in 38.1% of AD patients. Among the coagulase-negative staphylococci (CNS) identified, S. epidermidis was the common type and several other CNS were detected in both AD patients and HS. As the eruption grade of dermatitic skin became more severe, the average density of S. aureus increased (severe, 2.68 ± 0.86; moderate, 2.49 ± 0.48; mild, 2.28 ± 0.44). A reversed tendency was seen in S. epidermidis (severe, 1.80; moderate, 1.90; mild, 2.10). Among nine antimicrobial drugs tested against S. aureus, S. epidermidis, and some other types of CNS isolates, vancomycin (VCM) and minocycline (MINO) were the most active, gentamycin (GM) was the less active, and ampicillin (ABPC) was the least active. Conclusions The skin of AD patients was more frequently colonized with S. aureus than that of normal controls. As the severity of the AD lesions increased, the numbers of S. aureus isolated increased. The skin of HS was more colonized with S. epidermidis. Other species of CNS were isolated from several cases of AD patients and HS. In addition, S. aureus, S. epidermidis, and the other CNS showed poor susceptibility to some of the tested antimicrobial drugs.

119 citations

Journal ArticleDOI
TL;DR: This study demonstrates the rapid emergence of antibiotic-resistant bacteria as a problem of growing significance in hospital dermatology and highlights the importance of local surveillance programs to aid in selecting antibiotic treatments.
Abstract: Background Results of an ongoing surveillance of antibiotic resistance in hospitalized dermatology patients are presented. Bacterial isolates cultured from patients with skin wounds admitted to a tertiary care dermatology inpatient unit from May 1995 through May 1996 were evaluated for resistance to commonly used antibiotics. Comparison was made with a previous survey of the same inpatient service from 1992. Our results show an alarming trend toward antibiotic resistance. Observation In superficial skin wounds,Staphylococcus aureusconstituted 77% of isolates. In leg ulcers, the frequencies ofS aureusandPseudomonas aeruginosawere approximately equal, constituting 43% and 42% of cultures, respectively. Fifty percent ofS aureusisolates from leg ulcers were resistant to oxacillin, with 36% of pseudomonad isolates resistant to ciprofloxacin. In superficial wounds, oxacillin resistance inS aureusapproached 25%. A comparison of antibiotic resistance profiles using data collected in 1992 for patients admitted to the same inpatient service revealed a marked increase in oxacillin and ciprofloxacin resistance inS aureusandP aeruginosain leg ulcers, respectively (from 24% to 50% oxacillin resistance inS aureusand from 9% to 24% ciprofloxacin resistance inP aeruginosa), and superficial wounds (24% to 36% ciprofloxacin resistance inP aeruginosa). Conclusions This study demonstrates the rapid emergence of antibiotic-resistant bacteria as a problem of growing significance in hospital dermatology and highlights the importance of local surveillance programs to aid in selecting antibiotic treatments.

95 citations

References
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Book
01 Mar 1991
TL;DR: The role of the Clinical Microbiology Laboratory in Nosocomial and Community Infections and Antimicrobial Agents and Susceptibility Tests, Quality Control, Media, Reagents and Stains is examined.
Abstract: General Issues in Clinical Microbiology Diagnostic Technologies in Clinical Microbiology Nosocomial and Community Infections: the Role of the Clinical Microbiology Laboratory Bacteria Fungi Parasites Viruses Rickettsiae and Chlamydiae Antimicrobial Agents and Susceptibility Tests Quality Control, Media, Reagents and Stains.

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TL;DR: A new cephalosporin with a highly reactive β- lactam ring was found to give an immediate color change in the presence of β-lactamases from many bacteria, including staphylococci, Bacillus species, Enterobacteriaceae, and Pseudomonas.
Abstract: A new cephalosporin with a highly reactive β-lactam ring was found to give an immediate color change in the presence of β-lactamases from many bacteria, including staphylococci, Bacillus species, Enterobacteriaceae, and Pseudomonas. The reaction is confined to organisms producing β-lactamases, but it is sufficiently sensitive to indicate the presence of this enzyme is small amounts in strains previously considered not to produce it. The compound has an unusual ultraviolet spectrum, and the color change can be followed quantitatively by measuring changes in absorption which occur in the 380- to 500-nm region, where cephalosporins normally have no absorption. The development of color is thought to be a consequence of the β-lactam ring being unusually highly conjugated with the 3-substituent. Although in the bacteria only β-lactamases produce this color change, it was found that serum and tissues from experimental animals also rapidly produced the colored breakdown product, which was then excreted in the urine. The mechanism of the mammalian breakdown was considered to be different from that found in bacteria.

1,840 citations

Journal ArticleDOI
TL;DR: Systemic and topical antibiotic therapy pro‐duced a profound decrease in Staph.
Abstract: SUMMARY Quantitative aerobic cultures were obtained from fifty patients with chronic plaques, and from twenty with exudative lesions of atopic dermatitis. In the former, Staphylococcus aureus was isolated from 90% and the density exceeded 1 × 106/cm2 in 45% of the samples. In the exudative form, Staph. aureus was recovered in every case with a mean density of 14 × 106 organisms per cm2. Staph. aureus was the dominant organism not only in the lesions but in nearby clinically normal skin. Despite these high numbers, clinical signs of infection were lacking. Systemic and topical antibiotic therapy pro-duced a profound decrease in Staph. aureus density. It is proposed that high numbers of Staph. aureus may aggravate the underlying lesion and be the source of Staph. aureus infections in contacts.

806 citations

Book
01 Jan 1974
TL;DR: As one of the part of book categories, human intestinal flora always becomes the most wanted book.
Abstract: If you really want to be smarter, reading can be one of the lots ways to evoke and realize. Many people who like reading will have more knowledge and experiences. Reading can be a way to gain information from economics, politics, science, fiction, literature, religion, and many others. As one of the part of book categories, human intestinal flora always becomes the most wanted book. Many people are absolutely searching for this book. It means that many love to read this kind of book.

447 citations