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Scott Walsh, MD., Sunnybrook Research Institute, Toronto, ON Atopic dermatitis (AD) is an inflammatory, chronically relapsing skin condition that gives rise to dry itchy skin. This, in combination with environmental and genetically determined factors results in AD patients being predisposed to colonization by the pathogenic bacterium, Staphylococcus aureus. It has long been suspected that S. aureus can aggravate or directly cause skin irritation in AD patients, with risk of secondary infection. A recent alarming trend is the circulation in the community of S. aureus strains that are resistant to antibiotic, and capable of causing severe and fatal infection in children and healthy adults. Therefore, children with AD are at risk for colonization and infection by these strains. In spite of this, and the long-standing historic association of S. aureus with AD patients, very little is known about the strains that colonize these patients. This project will undertake the first systematic genetic analysis of S. aureus strains isolated from AD patients, to determine if there are specific strains that associate with AD skin, and to monitor for emergence of hypervirulent community acquired S. aureus strains in this large patient community. It is anticipated that the resulting data can be used towards more effective management of S. aureus colonization in AD patients, identify problematic strains associated with more severe forms of the disease, and through continued monitoring, to ensure the safety of the AD community through the early detection of severe community acquired strains. Peer-reviewed publications supported by the Canadian Dermatology Foundation 1. Neuman MG, Shear NH, Malkiewicz IM, Taeri M, Shapiro LE, Krivoy N, Haber J, Gomez M, Fish J, Cartotto R, Cohen L. Immunopathogenesis of hypersensitivity syndrome reactions to sulfonamides. Translational Research 2007; 149: 243 – 253. 2. Phillips EJ, Wong GA, Kaul R, Shahabi K, Nolan DA, Knowles SR, Martin AM, Mallal S, Shear NH. Clinical and immunogenetic correlates of abacavir hypersensitivity. AIDS 2005; 19: 979 – 87. 3. Wong GAE, Shear NH. Is a drug alone sufficient to cause the drug hypersensitivity syndrome? Arch Dermatol 2004;140 226-230. 4. Knowles S, Shapiro L, Shear NH. Reactive metabolites and adverse drug reactions: clinical considerations. Clin Rev Allergy Immunol. 2003; 24(3):229-38. ©2008 |
