Abstract
Background
Atopic dermatitis (AD) is a prevalent disease with significant impact on physical health and quality of life. Staphylococcus aureus (S. aureus) has been directly correlated to disease severity, and may also be a contributing causal factor in the pathogenesis of AD. The primary aim of the present study was to assess differences in S. aureus colonization in AD patients with and without filaggrin gene (FLG) mutations. Secondarily, to assess disease severity in relation to S. aureus colonization. Exploratory analyses were performed to investigate S. aureus genetic lineages in relation to FLG mutations and disease severity (SCORAD).
Methods
101 adult AD patients were included in the study. Bacterial swabs were taken from lesional skin, non-lesional skin and nose. Swabs positive for S. aureus were characterized by spa and the respective clonal complex (CC) type assigned. Patients were characterized with respect to disease severity (SCORAD) and FLG mutations (n=88). Fischer's exact test was used to analyze differences in S. aureus colonization in relation to FLG mutations.
Results
Of the 101 patients included, 74 patients (73%) were colonized with S. aureus. Of the colonized patients, 70 patients (95%) carried only one CC type in all three different sampling sites. In lesional skin S. aureus was found in 24 patients with FLG mutations (n=31), versus 24 wild-type patients (n=54) (p=0.0004). S. aureus CC1 clonal lineage was more prevalent in patients with FLG mutations (n=10) than in wild-type patients (n=2) (p=0.003). No specific bacterial lineage was linked to disease severity.
Conclusion
Increased S. aureus colonization in AD patients with FLG mutations, and increased prevalence of CC1 in patients with FLG mutations, suggest that host-microbe interactions and clonal differences in S. aureus are important for colonization of AD skin.
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