特应性皮炎患者金黄色葡萄球菌皮肤病变定植

Colonization of Staphylococcus aureus in patients with atopic dermatitis

目的分析特应性皮炎(AD)患者急性和慢性皮肤病变中金黄色葡萄球菌的定植率,并探讨年龄、免疫球蛋白E(IgE)和嗜酸性粒细胞计数对金黄色葡萄球菌定植的影响。方法选取2011年11月-2020年7到北京协和医院就诊的487例AD患者(270例儿童,217例成年人;95处急性皮肤病变和392处慢性皮肤病变)作为研究组,并选取同期171名(70名儿童,101名成年人)无任何皮肤病变者为对照组。采集皮损部位金黄色葡萄球菌,以Immuno-CAPTM荧光酶联试验检测血清IgE,采用XE-2100激光流式细胞仪进行血嗜酸性粒细胞计数测定。结果金黄色葡萄球菌在急性皮肤病变、慢性皮肤病变和正常对照皮肤的定植率分别是78.95%,39.03%和8.19%。而且金黄色葡萄球菌在皮损部位的定植率随着年龄的增长而增加。与正常IgE/嗜酸性粒细胞组患者相比,高IgE/嗜酸性粒细胞组患者的慢性皮肤病变部位,金黄色葡萄球菌的定植率更高。结论AD患者急性皮肤病变的葡萄球菌定植率较高,并有随年龄增长而增加的趋势。由于金黄色葡萄球菌定植率仅在慢性皮肤病变的高IgE/嗜酸性粒细胞患者中较高,或许可使用这两个参数作为AD患者慢性皮损中金黄色葡萄球菌定植的预测标志物。

OBJECTIVE To analyze the colonization rate of Staphylococcus aureus(SA)in acute and chronic skin lesions of atopic dermatitis(AD)patients,to explore the effects of age,immunoglobulin E(IgE),and eosinophil count on Staphylococcus aureus colonization.METHODS A total of 487 AD patients(270 children,217 adults;95 acute skin lesions and 392 chronic skin lesions)who were admitted to Peking Union Medical College Hospital from Nov.2011 to Jul.2020 were selected as the study group,and 171 patients(70 children,101 adults)without any skin lesions during the same period were selected as the control group.Staphylococcus aureus was collected from skin lesions,serum IgE was detected by Immuno-CAPTM fluorescence enzyme-linked assay,and blood eosinophils were counted by XE-2100 laser flow cytometer.RESULTS The colonization rates of SA in acute skin lesions,chronic skin lesions and normal control skin were 78.95%,39.03%and 8.19%,respectively.Moreover,the colonization rate of SA in the skin lesions increased with age.Compared with patients in the normal IgE/eosinophil group,patients in the high IgE/eosinophilia groups had higher rates of S.aureus colonization of chronic skin lesions.CONCLUSION The rate of SA colonization in acute lesions in AD patients was high and tended to increase with age.Since the colonization rates of SA were only higher in the high IgE/eosinophilia patients with chronic skin lesions,it might be possible to use these two parameters as predictive markers for SA colonization in chronic skin lesions in AD patients.