Relação entre a colonização por Staphylococcus spp. e dermatite atópica: perfil de virulência e sua influência na gravidade da doença
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Data
2023-06-07
Autores
Angulski, Luís Felipe Ramos Berbel
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
A dermatite atópica (DA) é uma doença inflamatória cutânea crônica, de etiologia multifatorial, que se manifesta clinicamente sob a forma de eczema. A maioria dos pacientes com DA está colonizada por Staphylococcus aureus capaz de produzir vários fatores de virulência. S. aureus exerce um papel importante no desenvolvimento da doença, podendo a diferenciação da expressão de toxinas, bem como o grau de resistência aos antibióticos, influenciar diretamente na gravidade da DA. Neste estudo, caracterizou-se a comunidade estafilocócica cutânea e nasal de pacientes pediátricos com DA (n=100) e a presença do gene mecA de resistência à meticilina nas amostras de S. aureus isoladas. As espécies isoladas da mucosa nasal e pele de doentes (lesões agudas e crônicas) com DA foram submetidas às técnicas de PCR para identificação de bactérias pertencentes às espécies S. aureus e estafilococos coagulase-negativa (ECN), incluindo S. epidermidis, através de fragmentos específicos de DNA encontrados nesses micro-organismos. O estudo procurou verificar a associação entre a colonização pelo S. aureus e ECN nos pacientes com DA e a gravidade da doença, pelo escore clínico SCORAD. Foi observada uma prevalência de colonização por S. aureus de 73%, por S. epidermidis de 36%, outros ECN 58% e Gram-negativos 18%. A pesquisa do gene mecA realizada em amostras de S. aureus detectou MRSA em 10 pacientes e em 8 pacientes colonizados por S. epidermidis, não sendo estatisticamente significativa a correlação entre a expressão deste gene e a gravidade da DA. Foi identificada a prevalência da expressão fenotípica, pelo método de aglutinação em látex (RPLA), das seguintes enterotoxinas: SEA de 12,3%, SEB de 19,1%, SEC de 28,8% e SED de 8,2%. Houve correlação significativa entre a mediana do SCORAD com a expressão das enteroxinas SEA e SED. A caracterização detalhada, o perfil de virulência e resistência antimicrobiana desses micro-organismos podem ser úteis para o cuidado dos pacientes e desenvolvimento de estratégias que poderiam ser utilizadas no controle e na terapêutica de pacientes com DA.
Atopic dermatitis (AD) is a chronic inflammatory disease of multifactorial etiology, which clinically manifests itself in the form of eczema. Most patients with AD are colonized by Staphylococcus aureus capable of producing several virulence factors. S. aureus plays an important role in the development of the disease, being able to differentiate the expression of proteins, as well as the degree of resistance to antibiotics, directly influencing the severity of AD. In this study, we characterized the cutaneous and nasal staphylococcal community of pediatric AD patients (n=100) and the presence of the methicillin resistance gene mecA in S. aureus exception care. Pediatric species from the nasal mucosa and skin of patients (acute and chronic lesions) with AD were maintained using PCR techniques to identify bacteria belonging to the species S. aureus and coagulase-negative staphylococci (ECN), including S. epidermidis, through specific fragments of DNA found in these microorganisms. The study sought to verify the association between S. aureus colonization and NEC in patients with AD and disease severity, using the SCORAD clinical score. There was a prevalence of colonization by S. aureus of 73%, by S. epidermidis of 36%, others NEC 58% and Gram-negative 18%. Research on the mecA gene carried out in a sample of S. aureus detected MRSA in 10 patients and in 8 patients colonized by S. epidermidis, with no statistically significant difference between the expression of this gene and the severity of AD. The prevalence of phenotypic expression was monitored, by the latex agglutination method (RPLA), of the following enterotoxins: SEA 12.3%, SEB 19.1%, SEC 28.8% and SED 8.2%. There was significance between the median of SCORAD and the expression of enteroxins SEA and SED. The detailed characterization, virulence profile and antimicrobial resistance of these microorganisms can be useful for patient care and development of strategies that could be used in the control and therapy of patients with AD.
Atopic dermatitis (AD) is a chronic inflammatory disease of multifactorial etiology, which clinically manifests itself in the form of eczema. Most patients with AD are colonized by Staphylococcus aureus capable of producing several virulence factors. S. aureus plays an important role in the development of the disease, being able to differentiate the expression of proteins, as well as the degree of resistance to antibiotics, directly influencing the severity of AD. In this study, we characterized the cutaneous and nasal staphylococcal community of pediatric AD patients (n=100) and the presence of the methicillin resistance gene mecA in S. aureus exception care. Pediatric species from the nasal mucosa and skin of patients (acute and chronic lesions) with AD were maintained using PCR techniques to identify bacteria belonging to the species S. aureus and coagulase-negative staphylococci (ECN), including S. epidermidis, through specific fragments of DNA found in these microorganisms. The study sought to verify the association between S. aureus colonization and NEC in patients with AD and disease severity, using the SCORAD clinical score. There was a prevalence of colonization by S. aureus of 73%, by S. epidermidis of 36%, others NEC 58% and Gram-negative 18%. Research on the mecA gene carried out in a sample of S. aureus detected MRSA in 10 patients and in 8 patients colonized by S. epidermidis, with no statistically significant difference between the expression of this gene and the severity of AD. The prevalence of phenotypic expression was monitored, by the latex agglutination method (RPLA), of the following enterotoxins: SEA 12.3%, SEB 19.1%, SEC 28.8% and SED 8.2%. There was significance between the median of SCORAD and the expression of enteroxins SEA and SED. The detailed characterization, virulence profile and antimicrobial resistance of these microorganisms can be useful for patient care and development of strategies that could be used in the control and therapy of patients with AD.
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Palavras-chave
Dermatite atópica, Fatores de virulência, Medicina tropical, Virulência (Microbiologia), Atopic dermatitis, Staphylococcus, Staphylococcus aureus, Staphylococcus spp