Characterization of wound microbes in epidermolysis bullosa: Results from the epidermolysis bullosa clinical characterization and outcomes database.


Journal

Pediatric dermatology
ISSN: 1525-1470
Titre abrégé: Pediatr Dermatol
Pays: United States
ID NLM: 8406799

Informations de publication

Date de publication:
Jan 2021
Historique:
received: 14 06 2020
revised: 07 10 2020
accepted: 12 10 2020
pubmed: 29 11 2020
medline: 15 5 2021
entrez: 28 11 2020
Statut: ppublish

Résumé

Patients with epidermolysis bullosa (EB) require care of wounds that are colonized or infected with bacteria. A subset of EB patients are at risk for squamous cell carcinoma, and bacterial-host interactions have been considered in this risk. The EB Clinical Characterization and Outcomes Database serves as a repository of information from EB patients at multiple centers in the United States and Canada. Access to this resource enabled broad-scale analysis of wound cultures. A retrospective analysis of 739 wound cultures from 158 patients from 13 centers between 2001 and 2018. Of 152 patients with a positive culture, Staphylococcus aureus (SA) was recovered from 131 patients (86%), Pseudomonas aeruginosa (PA) from 56 (37%), and Streptococcus pyogenes (GAS) from 34 (22%). Sixty-eight percent of patients had cultures positive for methicillin-sensitive SA, and 47%, methicillin-resistant SA (18 patients had cultures that grew both methicillin-susceptible and methicillin-resistant SA at different points in time). Of 15 patients with SA-positive cultures with recorded mupirocin susceptibility testing, 11 had mupirocin-susceptible SA and 6 patients mupirocin-resistant SA (2 patients grew both mupirocin-susceptible and mupirocin-resistant SA). SCC was reported in 23 patients in the entire database, of whom 10 had documented wound cultures positive for SA, PA, and Proteus species in 90%, 50%, and 20% of cases, respectively. SA and PA were the most commonly isolated bacteria from wounds. Methicillin resistance and mupirocin resistance were reported in 47% and 40% of patients tested, respectively, highlighting the importance of ongoing antimicrobial strategies to limit antibiotic resistance.

Sections du résumé

BACKGROUND/OBJECTIVES OBJECTIVE
Patients with epidermolysis bullosa (EB) require care of wounds that are colonized or infected with bacteria. A subset of EB patients are at risk for squamous cell carcinoma, and bacterial-host interactions have been considered in this risk. The EB Clinical Characterization and Outcomes Database serves as a repository of information from EB patients at multiple centers in the United States and Canada. Access to this resource enabled broad-scale analysis of wound cultures.
METHODS METHODS
A retrospective analysis of 739 wound cultures from 158 patients from 13 centers between 2001 and 2018.
RESULTS RESULTS
Of 152 patients with a positive culture, Staphylococcus aureus (SA) was recovered from 131 patients (86%), Pseudomonas aeruginosa (PA) from 56 (37%), and Streptococcus pyogenes (GAS) from 34 (22%). Sixty-eight percent of patients had cultures positive for methicillin-sensitive SA, and 47%, methicillin-resistant SA (18 patients had cultures that grew both methicillin-susceptible and methicillin-resistant SA at different points in time). Of 15 patients with SA-positive cultures with recorded mupirocin susceptibility testing, 11 had mupirocin-susceptible SA and 6 patients mupirocin-resistant SA (2 patients grew both mupirocin-susceptible and mupirocin-resistant SA). SCC was reported in 23 patients in the entire database, of whom 10 had documented wound cultures positive for SA, PA, and Proteus species in 90%, 50%, and 20% of cases, respectively.
CONCLUSIONS CONCLUSIONS
SA and PA were the most commonly isolated bacteria from wounds. Methicillin resistance and mupirocin resistance were reported in 47% and 40% of patients tested, respectively, highlighting the importance of ongoing antimicrobial strategies to limit antibiotic resistance.

Identifiants

pubmed: 33247481
doi: 10.1111/pde.14444
pmc: PMC7906915
mid: NIHMS1637008
doi:

Substances chimiques

Anti-Bacterial Agents 0
Mupirocin D0GX863OA5

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

119-124

Subventions

Organisme : NICHD NIH HHS
ID : K23 HD091295
Pays : United States
Organisme : Epidermolysis Bullosa Research Partnership
ID : CU16-2131

Informations de copyright

© 2020 Wiley Periodicals LLC.

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Auteurs

Laura E Levin (LE)

Department of Dermatology, Columbia University Irving Medical Center, New York, NY, USA.

Leila H Shayegan (LH)

Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.

Anne W Lucky (AW)

Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

Kristen P Hook (KP)

Department of Dermatology, University of Minnesota Medical School, Minneapolis, MN, USA.

Anna L Bruckner (AL)

Departments of Dermatology and Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA.

James A Feinstein (JA)

Departments of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA.

Susan Whittier (S)

Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, NY, USA.

Christine T Lauren (CT)

Departments of Pediatrics and Dermatology, Columbia University Irving Medical Center, New York, NY, USA.

Elena Pope (E)

Section of Dermatology, Division of Paediatric Medicine, Hospital for Sick Children, Toronto, ON, Canada.

Irene Lara-Corrales (I)

Section of Dermatology, Division of Paediatric Medicine, Hospital for Sick Children, Toronto, ON, Canada.

Karen Wiss (K)

Division of Dermatology, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA.

Catherine C McCuaig (CC)

Departments of Pediatrics and Dermatology, CHU Sainte-Justine, University of Montreal, Montreal, QC, Canada.

Julie Powell (J)

Department of Dermatology, CHU Sainte-Justine, University of Montreal, Montreal, QC, Canada.

Lawrence F Eichenfield (LF)

Departments of Pediatrics and Dermatology, University of California San Diego, San Diego, CA, USA.

Moise L Levy (ML)

Departments of Pediatrics and Dermatology, Dell Children's Medical Center, Austin, TX, USA.

Lucia Diaz (L)

Department of Dermatology, Dell Children's Medical Center, Austin, TX, USA.

Sharon A Glick (SA)

Department of Dermatology, State University of New York Downstate Medical Center, Brooklyn, NY, USA.

Amy S Paller (AS)

Departments of Pediatrics and Dermatology, Northwestern University, Chicago, IL, USA.

Harper N Price (HN)

Department of Dermatology, Phoenix Children's Hospital, Phoenix, AZ, USA.

John C Browning (JC)

Department of Dermatology, The Children's Hospital of San Antonio, San Antonio, TX, USA.

Kimberly D Morel (KD)

Departments of Pediatrics and Dermatology, Columbia University Irving Medical Center, New York, NY, USA.

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