Allergy Asthma Respir Dis.  2017 Jul;5(4):193-199. 10.4168/aard.2017.5.4.193.

The association between Staphylococcus aureus colonization and food sensitization in children with atopic dermatitis

• Hwang YH
• Lee SH
• Kim BK
• Kim SW

• KMID: 2387646
• DOI: http://doi.org/10.4168/aard.2017.5.4.193

Abstract

PURPOSE
Atopic dermatitis is often accompanied by food allergies which occur through skin barrier defects. Especially Staphylococcus aureus colonization can exacerbate skin barrier defects that cause sensitization and increase specific IgE (sIgE) to food. We investigated the association between skin colonization and food sIgE changes in children with atopic dermatitis.
METHODS
Atopic dermatitis was diagnosed by a pediatric allergist in patients between 3 months and 3 years of age. Total IgE and sIgE to egg white, cow's milk, wheat, and peanuts were taken. Eosinophil count and eosinophil cationic protein were also taken. Comparisons were done between the groups with and without S. aureus colonization.
RESULTS
It was found that 50.3% of the 294 enrolled patients had S. aureus colonization on lesional skin. Statistically significant sensitization to wheat and peanut were increased with S. aureus colonization. Statistically significant increases in sIgE (above cutoff level) were also found in egg white, milk, wheat and peanut. Higher S. aureus colony counts also increased sIgE of all foods. Methicillin-resistant S. aureus showed no statistical difference compared to methicillin-susceptible S. aureus in severity and sIgE levels.
CONCLUSION
S. aureus colonization increases the risk of food sensitization in children with atopic dermatitis.

Keyword

Atopic dermatitis; Food allergy; Staphylococcus aureus

MeSH Terms

Arachis
Child*
Colon*
Dermatitis, Atopic*
Egg White
Eosinophil Cationic Protein
Eosinophils
Food Hypersensitivity
Humans
Immunoglobulin E
Methicillin Resistance
Milk
Skin
Staphylococcus aureus*
Staphylococcus*
Triticum
Eosinophil Cationic Protein
Immunoglobulin E

Figure

• 

  Fig. 1. Comparisons of total IgE (A), eosinophil count (B), and eosinophil cationic protein (ECP) (C) were done between the groups with and without Staphylococus aureus colonization. S. aureus colonization showed statistically significant (P<0.05) increases in total IgE, eosinophil count, and ECP compared to the group without colonization. ∗∗ P<0.01.

• 

  Fig. 2. Comparisons of specific IgE (slgE) (egg white [A], cow's milk [B], wheat [C], and peanuts [D]) were done between the groups with and without Staphylococus aureus colonization. Statistically significant (P<0.05) differences were showed in all slgE between 2 groups. ∗ P<0.05. ∗∗ P<0.01.

• 

  Fig. 3. Comparisons of total IgE (A), eosinophil count (B), and cationic protein (ECP) (C) were done between the groups with and without sensitization to methicillin. Statistically significant (P<0.05) differences in total IgE, eosinophil count, and ECP were not found between the methicillin resistant and nonresistant groups. MSSA, methicillin-susceptible Staphylococcus aureus; MRSA, methichillin-resistant Staphylococcus aureus.

• 

  Fig. 4. Comparisons of specific IgE (slgE) were done between methicillin resistant and nonresistant groups. The results were not statistically significant according to each slgE. Methicillin resistant versus nonresistant slgE results were egg white (A), milk (B), wheat (C), and peanuts (D), respectively. The resistant group showed higher values but were not statistically significant (P>0.05). MSSA, methicillin-susceptible Staphylococcus aureus; MRSA, methichillin-resistant Staphylococcus aureus.

• 

  Fig. 5. We investigated the association between Staphylococus aureus colony counts and specific lgE (slgE). Statistically significant increments in slgE for peanuts were found with proportional increase in S. aureus colony count. More than 30 colonies vs. less than 30 colonies slgE were egg white (A), milk (B), wheat (C), and peanuts (D), respectively. ∗ P<0.05.

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