Methicillin-resistant and methicillin-sensitive Staphylococcus aureus isolates from skin and nares of Brazilian children with atopic dermatitis demonstrate high level of clonal diversity

PLoS One. 2022 Nov 3;17(11):e0276960. doi: 10.1371/journal.pone.0276960. eCollection 2022.

Abstract

Background: Atopic dermatitis (AD) primarily affects the pediatric population, which is highly colonized by S. aureus. However, little is known about the genetic features of this microorganism and other staphylococcal species that colonize AD patients.

Objective: This study aimed to characterize Staphylococcus spp. isolated from the nares and skin (with and without lesion) of 30 AD and 12 non-AD Brazilian children.

Methods: Skin and nasal swabs were cultured onto mannitol salt agar, and bacterial colonies were counted and identified by matrix assisted laser desorption ionization time of flight mass spectrometry and polymerase chain reaction (PCR). Antimicrobial susceptibility was evaluated by phenotypic and genotypic tests. In S. aureus isolates, Panton-Valentine leukocidin genes were detected by PCR, and their clonality was assessed by pulsed-field gel electrophoresis and multilocus sequence typing.

Results: S. aureus was more prevalent in the nares (P = 0.005) and lesional skin (P = 0.0002) of children with AD, while S. hominis was more frequent in the skin of non-AD children (P < 0.0001). All children in the study, except one from each group, were colonized by methicillin-resistant coagulase-negative Staphylococcus and 24% by methicillin-resistant S. aureus. Despite the great clonal diversity of S. aureus (18 sequence types identified), most AD children (74.1%) were colonized by the same genotype in both niches.

Conclusion: High colonization by polyclonal S. aureus isolates was found among children with AD, while S. hominis was more frequent among non-AD children. The high prevalence of methicillin-resistant staphylococcal isolates highlights the importance of continued surveillance, especially when considering empiric antibiotic therapy for the treatment of skin infections in these patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Brazil / epidemiology
  • Child
  • Dermatitis, Atopic* / epidemiology
  • Humans
  • Methicillin
  • Methicillin Resistance
  • Methicillin-Resistant Staphylococcus aureus*
  • Microbial Sensitivity Tests
  • Staphylococcal Infections* / microbiology
  • Staphylococcus
  • Staphylococcus aureus / genetics

Substances

  • Methicillin

Grants and funding

Author who received each award: a) KRNS This study was supported by Brazilian grants from Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ, grants #E-26/202.592/2019, #E-26/010.000172/2016, #E-26/010.001463/2019, #E-26/010.101056/2018; #E-26/211.554/2019 (Projeto REDES); #E-26/201.071/2020; and #E-26/211.284/2021), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq, grants #307594/2021-1 and #26.210.875/2016), and Coordenação de Aperfeiçoamento Pessoal de Nível Superior – Brasil (CAPES)– Finance Code 001. B) DCF This study was supported by Brazilian grants from Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ, grants #E-26/203.296/2017; and #E-26/201.454/2021). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.