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Pascolini C. 1, Prignano G. 1, Passariello C. 2, Pecetta S. 2, Capitanio B. 3, Ensoli F. 1, Di Carlo A. 4
1 Unità Operativa Complessa di Patologia Clinica e Microbiologia, Istituto Dermatologico San Gallicano, Roma, Italia
2 Dipartimento Sanità Pubblica e Malattie Infettive, Università “La Sapienza”, Roma, Italia
3 Unità Operativa Semplice di Dermatologia Pediatrica, Istituto Dermatologico San Gallicano, Roma, Italia
4 Direzione Scientifica, Istituto Dermatologico San Gallicano, Roma, Italia
Aim. Atopic dermatitis (AD) is characterized by a dysfunctional skin, that is particularly susceptible to Staphylococcus aureus colonization (prevalence over 70-80%), which produces toxins that can contribute to the exacerbation of symptoms.
Methods. The present study evaluated the presence of S. aureus in 175 pediatric patients affected by AD and in 195 cohabitants of patients in relation with severity of disease to identify a more effective clinical management of patients. Isolated strains were characterized for the presence of superantigen toxins genes (PCR analysis), and to evaluate the existence of phylogenetic relations within the family (PFGE analysis).
Results. Our data showed that both patients and their cohabitants had a higher prevalence of S. aureus infection/colonization as compared to controls and that colonization was proportional to severity of disease. Moreover, bacterial isolates were characterized at the genomic level showing the existence of clonal identity among isolates from different sites of the same patient and between isolates from a patient and its cohabitants. This observation suggests that bacteria diffuse from nasal reservoirs to skin lesions and circulate within the family of each patient.
Conclusion. The experimental evidences enabled us to demonstrate that the family environment is a source of infection/reinfection for patients and a source of risk for cohabitants. Therefore, it is necessary to identify correct protocols to prevent intrafamiliar circulation in order to interrupt this chain of transmission.