학술논문
Characterization of wound microbes in epidermolysis bullosa: Results from the epidermolysis bullosa clinical characterization and outcomes database
Document Type
article
Author
Levin, Laura E; Shayegan, Leila H; Lucky, Anne W; Hook, Kristen P; Bruckner, Anna L; Feinstein, James A; Whittier, Susan; Lauren, Christine T; Pope, Elena; Lara‐Corrales, Irene; Wiss, Karen; McCuaig, Catherine C; Powell, Julie; Eichenfield, Lawrence F; Levy, Moise L; Diaz, Lucia; Glick, Sharon A; Paller, Amy S; Price, Harper N; Browning, John C; Morel, Kimberly D
Source
Pediatric Dermatology. 38(1)
Subject
Language
Abstract
Background/objectivesPatients 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.MethodsA retrospective analysis of 739 wound cultures from 158 patients from 13 centers between 2001 and 2018.ResultsOf 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.ConclusionsSA 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.