Microbiological assessment of the effectiveness of standard therapy in atopic dermatitis.

Abstract

Background: Atopic dermatitis is an inflammatory skin disease characterized by recurrent lesions and intense pruritus. Nowadays there is a stepwise approach to the treatment of atopic dermatitis, which is defined by disease intensity and complications such as secondary skin infections. However, the current management of atopic dermatitis may not always lead to the expected outcome due to not only immune dysregulation of both adaptive and innate immunity but also imbalance of the skin microbiome. Aims: The aim of the study was to evaluate changes in the composition of the skin microbiome in patients with atopic dermatitis during standard treatment. Materials and methods: Twenty patients with atopic dermatitis and twenty six healthy controls over 18 years old were included into the study. All microbiome samples were obtained from lesional and non-lesional skin sites of atopic dermatitis patients before and after therapy. Whereas samples from healthy controls were taken once from a flexor surface of the elbow. Species identification of clinical isolates were identified using MALDI Biotyper Sirius (Bruker Daltonics). Results: At baseline, the prevalence of S. aureus colonization among patients with atopic dermatitis was 34,20% in lesional skin and 32.50% in non-lesional skin. After therapy, the rate of S. aureus carriage decreased by 1.6 times (21.60%) in affected and by 2 times (15.6%) in unaffected skin. Interestingly, S. aureus was not found in healthy controls. Moreover, a quantitative estimation of S. aureus growth also demonstrated significant changes in the degree of colonization after treatment. The prevalence of confluent growth of S. aureus in inflamed atopic skin decreased more than 5 times. Conclusions: Thus, the results of the study showed the effectiveness of standard therapy for managing patients with atopic dermatitis by having a positive impact on the skin microbial community. There was a significant shift in both the qualitative and quantitative presence of S. aureus on the skin surface.