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Wiley InterScience

Clinical & Experimental Allergy

Clinical & Experimental Allergy

Volume 38 Issue 5, Pages 789 - 793

Published Online: 13 Mar 2008

© 2010 Blackwell Publishing Ltd



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ORIGINAL PAPER/Clinical Mechanisms in Allergic Disease
Severe atopic dermatitis is associated with a high burden of environmental Staphylococcus aureus
A. D. Leung * , A. M. Schiltz * , C. F. Hall * and A. H. Liu *†
  * Division of Allergy and Immunology, Department of Pediatrics, National Jewish Medical and Research Center, Denver, CO, USA and   Department of Pediatrics, University of Colorado Health Sciences Center, Denver, CO, USA
  Correspondence:
Andrew H. Liu, Department of Pediatrics, National Jewish Medical and Research Center, 1400 Jackson Street, Room K1023A, Denver, CO 80206, USA.
E-mail: liua@njc.org
Copyright Journal compilation © 2008 Blackwell Publishing Ltd
KEYWORDS
atopic dermatitis • Staphylococcus aureus

ABSTRACT

AbstractIntroductionMaterial and methodsResultsStaphylococcus aureus deoxyribonucleic acid in house dust and atopic dermatitis severityReferences

Background About 90% of patients with atopic dermatitis (AD) are colonized with Staphylococcus aureus. S. aureus worsens AD by secreting superantigens and structural molecules within the cell wall that induce skin inflammation. Therefore, S. aureus in the home may contribute to persistent skin inflammation and disease severity.

Objective To quantify S. aureus burden in homes of participants with AD of varying severities.

Methods Participants with mild (n=18), moderate (n=14), severe (n=15), and no AD (n=15), collected dust from their bed and bedroom floor, and from their home vacuum cleaner bag. DNA was extracted from dust samples, and the S. aureus-specific femB gene was quantified using quantitative real-time PCR. Data was log-transformed, and then statistically analysed with anova, student's t-test, and Spearman's r.

Results Participants with severe AD (geometric mean: 14.67 pg/mg dust) had significantly more S. aureus DNA in their bed dust than those with moderate (0.41 pg/mg dust, P<0.0001), mild (1.42 pg/mg dust, P=0.0051), and no AD [0.09 pg/mg dust, P<0.0001 (t-test)]. Similar patterns were observed for dust from the bedroom floors and vacuum bags. S. aureus DNA was highest in dust from beds as compared with bedroom floors or vacuum bags (medians: 1.51, 0.69, 0.21 pg/mg dust, respectively; P=0.007). Eczema Area and Severity Index scores correlated with S. aureus DNA from the bed (Spearman's r=0.7263; P=0.0004) and floor (0.6846; P=0.0002) dust, but not with the vacuum bag dust (0.3783; 0.0684).

Conclusions In the home and especially the bedroom, higher levels of S. aureus may contribute to disease severity and persistence in AD patients.


Submitted 10 August 2007; revised 20 November 2007; accepted 10 January 2008

DIGITAL OBJECT IDENTIFIER (DOI)
10.1111/j.1365-2222.2008.02964.x About DOI

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