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Year : 2014  |  Volume : 80  |  Issue : 3  |  Page : 229--234

Methicillin-resistant Staphylococcus aureus colonization and disease severity in atopic dermatitis: A cross-sectional study from South India

1 Department of Dermatology, Amrita Institute of Medical Sciences, Kochi, Kerala, India
2 Department of Dermatology and Venereology, Government Medical College, Kottayam, Kerala, India
3 Department of Community Medicine, Government Medical College, Kottayam, Kerala, India

Correspondence Address:
George Kurien
Department of Dermatology and Venereology, Government Medical College, Kottayam, Kerala
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0378-6323.132250

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Background: Colonization by methicillin-resistant Staphylococcus aureus (MRSA) in atopic dermatitis is little studied but has therapeutic implications. It may have a role in disease severity given the additional virulence factors associated. Aims: Our aims were to record the proportion of patients with MRSA colonization in atopic dermatitis and to ascertain if any association exists between MRSA colonization and disease severity. Methods: An observational cross-sectional study involving children aged≤12 years with atopic dermatitis attending the outpatient department of Government Medical College, Kottayam was conducted. Socio-demographic data, exacerbating factors and risk factors for hospital care-associated MRSA were documented. Extent of atopic dermatitis was recorded using a standardized scale (Eczema Area Severity Index, EASI). Skin swabs were taken from anterior nares and the worst affected atopic dermatitis sites for culture and sensitivity. Results: Of the 119 subjects recruited during the study period (November 2009-April 2011), Staphylococcus aureus was isolated from 110 (92.4%) patients and MRSA from 30 (25.21%) patients. A total of 18 patients with MRSA had risk factors for healthcare associated-MRSA. The patients whose cultures grew MRSA were found to have significantly higher EASI score when compared to those patients colonized with methicillin sensitive Staphylococcus aureus (P < 0.01). Presence of Staphylococcus aureus, early age of onset, presence of food allergies, seasonal exacerbation and inadequate breastfeeding did not seem to influence disease severity. Conclusions: There is a high degree of prevalence of MRSA (25.2%) in atopic dermatitis and presence of MRSA is associated with increased disease severity. Further studies are needed to validate these findings.


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