RESUMEN
BACKGROUND: Atopic dermatitis (AD) is a skin manifestation of atopy caused by hyperreactivity to various antigens. Studies have shown that 60-100% of patients with this condition present with colonization by Staphylococcus aureus. Given increasing rates of antimicrobial resistance, the sensitivity to antimicrobials of S. aureus colonizing atopic patients has been investigated. Cross-sectional studies worldwide suggest that the prevalence of methicillin-resistant S. aureus infection (MRSA) in the AD population varies from 0% to 30.8%. OBJECTIVES: The objectives of this study were to determinate the prevalence of S. aureus and MRSA in patients with AD in two dermatologic centers in Porto Alegre, Brazil. METHODS: A total of 91 patients with AD attending two dermatologic centers in Porto Alegre were enrolled in this study from December 2009 to July 2011. Two skin swabs were taken from each patient, one from the nares and the other from a non-infected eczematous skin lesion. The swabs were sent to the laboratory, where standard procedures to isolate bacteria and identify S. aureus, antimicrobial resistance, and sensitivity patterns were carried out. The severity of AD was defined using the Eczema Area and Severity Index (EASI). RESULTS: Of the 91 patients sampled, 67 (73.6%) patients were found to be positive for S. aureus colonization. Nasal swabs were positive in 55 (60.4%) patients, lesional swabs in 44 (48.4%) patients, and both lesional and nasal swabs were positive in 32 (35.2%) patients. Patients with positive swabs had a higher mean ± standard deviation EASI score [mean (9.1 ± 8.8)] compared with patients with negative swabs (3.9 ± 3.6) (P = 0.002). None of the 91 patients showed any evidence of MRSA infection. Overall, nearly 32% of the S. aureus isolated from nasal swabs and 36.40% of the S. aureus isolated from lesional swabs was resistant to erythromycin. CONCLUSIONS: The results of this study confirm a high rate of S. aureus colonization in pediatric patients with AD and indicate a relevant association between colonization and high EASI score. No MRSA was found in cultures from this sample of patients in southern Brazil. Nearly one-third of isolates were identified as resistant to erythromycin, an antibiotic that is commonly used in pediatric patients.
Asunto(s)
Dermatitis Atópica/tratamiento farmacológico , Dermatitis Atópica/epidemiología , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Infecciones Cutáneas Estafilocócicas/tratamiento farmacológico , Infecciones Cutáneas Estafilocócicas/epidemiología , Adolescente , Adulto , Distribución por Edad , Análisis de Varianza , Antibacterianos/uso terapéutico , Brasil/epidemiología , Distribución de Chi-Cuadrado , Niño , Preescolar , Infecciones Comunitarias Adquiridas/diagnóstico , Infecciones Comunitarias Adquiridas/tratamiento farmacológico , Infecciones Comunitarias Adquiridas/epidemiología , Estudios Transversales , Dermatitis Atópica/diagnóstico , Farmacorresistencia Bacteriana , Femenino , Humanos , Lactante , Masculino , Pruebas de Sensibilidad Microbiana , Prevalencia , Estudios Prospectivos , Índice de Severidad de la Enfermedad , Distribución por Sexo , Infecciones Cutáneas Estafilocócicas/diagnóstico , Adulto JovenRESUMEN
A Secretaria de Saúde e Meio Ambiente do Rio Grande dos Sul recebeu, entre 1983 e 1988, notificaçäo de 251 casos de SIDA. A análise dos casos notificados mostra incidência maior no sexo masculino, faixa etária entre 30-39 anos, com aumento de incidência no grupo dos drogados, hemofílicos, transmissäo perinatal e sexual. O maior número de casos é encontrado em centros urbanos, havendo uma prevalência de 10,68 casos / 1 milhäo de habitantes