Journal article
TSST-1(+) Staphylococcus aureus in Bullous Pemphigoid
Journal of investigative dermatology, Vol.142(4), pp.1032-1039.e6
04/01/2022
DOI: 10.1016/j.jid.2021.08.438
PMCID: PMC9215375
PMID: 34606884
Abstract
A potential role of Staphylococcus aureus in bullous pemphigoid was explored by examining the colonization rate in patients with new-onset disease compared with that in age- and sex-matched controls. S. aureus colonization was observed in 85% of bullous pemphigoid lesions, 3-6-fold higher than the nares or unaffected skin from the same patients (P <= 0.003) and 6-fold higher than the nares or skin of controls (P <= 0.0015). Furthermore, 96% of the lesional isolates produced the toxic shock syndrome toxin-1 superantigen, and most of these additionally exhibited homogeneous expression of the enterotoxin gene cluster toxins. Toxic shock syndrome toxin-1-neutralizing antibodies were not protective against colonization. However, S. aureus colonization was not observed in patients who had recently received antibiotics, and the addition of antibiotics with staphylococcal coverage eliminated S. aureus and resulted in clinical improvement. This study shows that toxic shock syndrome toxin-1-positive S. aureus is prevalent in bullous pemphigoid lesions and suggests that early implementation of antibiotics may be of benefit. Furthermore, our results suggest that S. aureus colonization could provide a source of infection in patients with bullous pemphigoid, particularly in the setting of high-dose immunosuppression.
Details
- Title: Subtitle
- TSST-1(+) Staphylococcus aureus in Bullous Pemphigoid
- Creators
- Kelly N. Messingham - Univ Iowa, Carver Coll Med, Dept Dermatol, 200 Grand Ave South,2080 ML, Iowa City, IA 52242 USAMichael P. Cahill - Roy J. and Lucille A. Carver College of MedicineSamuel H. Kilgore - Roy J. and Lucille A. Carver College of MedicineAnanya Munjal - Roy J. and Lucille A. Carver College of MedicinePatrick M. Schlievert - Roy J. and Lucille A. Carver College of MedicineJanet A. Fairley - Roy J. and Lucille A. Carver College of Medicine
- Resource Type
- Journal article
- Publication Details
- Journal of investigative dermatology, Vol.142(4), pp.1032-1039.e6
- Publisher
- Elsevier
- DOI
- 10.1016/j.jid.2021.08.438
- PMID
- 34606884
- PMCID
- PMC9215375
- ISSN
- 0022-202X
- eISSN
- 1523-1747
- Number of pages
- 14
- Grant note
- R21AG065980 / National Institute on Aging of the National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute on Aging (NIA) UL1TR002537 / National Center for Advancing Translational Sciences of the National Institutes of Health, Bethesda, MD University of Iowa, Iowa City, IA
- Language
- English
- Date published
- 04/01/2022
- Academic Unit
- Dermatology; Microbiology and Immunology
- Record Identifier
- 9984296211302771
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