Characterization of wound microbes in epidermolysis bullosa: Results from the epidermolysis bullosa clinical characterization and outcomes database

Background/Objectives Patients 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...

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Veröffentlicht in:Pediatric dermatology 2021-01, Vol.38 (1), p.119-124
Hauptverfasser: 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.
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container_end_page 124
container_issue 1
container_start_page 119
container_title Pediatric dermatology
container_volume 38
creator 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.
description Background/Objectives Patients 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. Methods A retrospective analysis of 739 wound cultures from 158 patients from 13 centers between 2001 and 2018. Results Of 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. Conclusions SA 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.
doi_str_mv 10.1111/pde.14444
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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. Methods A retrospective analysis of 739 wound cultures from 158 patients from 13 centers between 2001 and 2018. Results Of 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. Conclusions SA 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.</description><identifier>ISSN: 0736-8046</identifier><identifier>EISSN: 1525-1470</identifier><identifier>DOI: 10.1111/pde.14444</identifier><identifier>PMID: 33247481</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Anti-Bacterial Agents - therapeutic use ; Antibiotic resistance ; Antibiotics ; Bacteria ; Canada ; Cell culture ; cultures ; Epidermolysis bullosa ; Epidermolysis Bullosa - complications ; Epidermolysis Bullosa - drug therapy ; Genetic disorders ; Humans ; Methicillin ; microbes ; Microbiota ; Microorganisms ; Mupirocin ; Pediatrics ; resistance ; Retrospective Studies ; Skin diseases ; Squamous cell carcinoma ; Staphylococcal Infections - drug therapy ; Staphylococcus aureus ; Staphylococcus infections ; Streptococcus infections ; wound ; Wounds</subject><ispartof>Pediatric dermatology, 2021-01, Vol.38 (1), p.119-124</ispartof><rights>2020 Wiley Periodicals LLC.</rights><rights>Copyright © 2021 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4434-89644638024e4ffe20f4bc390b87f3fab907344b002f8c47b5072c840556cd6c3</citedby><cites>FETCH-LOGICAL-c4434-89644638024e4ffe20f4bc390b87f3fab907344b002f8c47b5072c840556cd6c3</cites><orcidid>0000-0003-0646-8192 ; 0000-0001-9393-6585 ; 0000-0002-7753-6503 ; 0000-0002-3210-3413 ; 0000-0002-6115-7584 ; 0000-0002-9516-8863 ; 0000-0003-0792-6247 ; 0000-0002-7278-4831</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fpde.14444$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fpde.14444$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,780,784,885,1416,27922,27923,45572,45573</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33247481$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Levin, Laura E.</creatorcontrib><creatorcontrib>Shayegan, Leila H.</creatorcontrib><creatorcontrib>Lucky, Anne W.</creatorcontrib><creatorcontrib>Hook, Kristen P.</creatorcontrib><creatorcontrib>Bruckner, Anna L.</creatorcontrib><creatorcontrib>Feinstein, James A.</creatorcontrib><creatorcontrib>Whittier, Susan</creatorcontrib><creatorcontrib>Lauren, Christine T.</creatorcontrib><creatorcontrib>Pope, Elena</creatorcontrib><creatorcontrib>Lara‐Corrales, Irene</creatorcontrib><creatorcontrib>Wiss, Karen</creatorcontrib><creatorcontrib>McCuaig, Catherine C.</creatorcontrib><creatorcontrib>Powell, Julie</creatorcontrib><creatorcontrib>Eichenfield, Lawrence F.</creatorcontrib><creatorcontrib>Levy, Moise L.</creatorcontrib><creatorcontrib>Diaz, Lucia</creatorcontrib><creatorcontrib>Glick, Sharon A.</creatorcontrib><creatorcontrib>Paller, Amy S.</creatorcontrib><creatorcontrib>Price, Harper N.</creatorcontrib><creatorcontrib>Browning, John C.</creatorcontrib><creatorcontrib>Morel, Kimberly D.</creatorcontrib><title>Characterization of wound microbes in epidermolysis bullosa: Results from the epidermolysis bullosa clinical characterization and outcomes database</title><title>Pediatric dermatology</title><addtitle>Pediatr Dermatol</addtitle><description>Background/Objectives Patients 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. Methods A retrospective analysis of 739 wound cultures from 158 patients from 13 centers between 2001 and 2018. Results Of 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. Conclusions SA 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.</description><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Antibiotic resistance</subject><subject>Antibiotics</subject><subject>Bacteria</subject><subject>Canada</subject><subject>Cell culture</subject><subject>cultures</subject><subject>Epidermolysis bullosa</subject><subject>Epidermolysis Bullosa - complications</subject><subject>Epidermolysis Bullosa - drug therapy</subject><subject>Genetic disorders</subject><subject>Humans</subject><subject>Methicillin</subject><subject>microbes</subject><subject>Microbiota</subject><subject>Microorganisms</subject><subject>Mupirocin</subject><subject>Pediatrics</subject><subject>resistance</subject><subject>Retrospective Studies</subject><subject>Skin diseases</subject><subject>Squamous cell carcinoma</subject><subject>Staphylococcal Infections - drug therapy</subject><subject>Staphylococcus aureus</subject><subject>Staphylococcus infections</subject><subject>Streptococcus infections</subject><subject>wound</subject><subject>Wounds</subject><issn>0736-8046</issn><issn>1525-1470</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kcFu1DAQhi0EokvhwAsgS1zKIa2dTByHAxJaSkGqBEJwtmxnzLpy4sVOWi2vwQtj2LaCCuYyh_n0_zPzE_KUs2Ne6mQ74DGHUvfIird1W3Ho2H2yYl0jKslAHJBHOV8wxqQQ_CE5aJoaOpB8RX6sNzppO2Py3_Xs40Sjo1dxmQY6epuiwUz9RHHrB0xjDLvsMzVLCDHrl_QT5iXMmboURzpv8N8ctcFP3upA7V0zXXziMts4Fp9Bz9rojI_JA6dDxifX_ZB8eXv6ef2uOv9w9n79-ryyAA1UshcAopGsBgTnsGYOjG16ZmTnGqdNX-4HMIzVTlroTMu62kpgbSvsIGxzSF7tdbeLGXGwOM1JB7VNftRpp6L26u_J5Dfqa7xUXc9Ez9sicHQtkOK3BfOsRp8thqAnjEtWNYgWoNjygj6_g17EJU3lvEL1dV9Sk7JQL_ZU-XzOCd3tMpypX1GrErX6HXVhn_25_S15k20BTvbAlQ-4-7-S-vjmdC_5E8LxtuQ</recordid><startdate>202101</startdate><enddate>202101</enddate><creator>Levin, Laura E.</creator><creator>Shayegan, Leila H.</creator><creator>Lucky, Anne W.</creator><creator>Hook, Kristen P.</creator><creator>Bruckner, Anna L.</creator><creator>Feinstein, James A.</creator><creator>Whittier, Susan</creator><creator>Lauren, Christine T.</creator><creator>Pope, Elena</creator><creator>Lara‐Corrales, Irene</creator><creator>Wiss, Karen</creator><creator>McCuaig, Catherine C.</creator><creator>Powell, Julie</creator><creator>Eichenfield, Lawrence F.</creator><creator>Levy, Moise L.</creator><creator>Diaz, Lucia</creator><creator>Glick, Sharon A.</creator><creator>Paller, Amy S.</creator><creator>Price, Harper N.</creator><creator>Browning, John C.</creator><creator>Morel, Kimberly D.</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-0646-8192</orcidid><orcidid>https://orcid.org/0000-0001-9393-6585</orcidid><orcidid>https://orcid.org/0000-0002-7753-6503</orcidid><orcidid>https://orcid.org/0000-0002-3210-3413</orcidid><orcidid>https://orcid.org/0000-0002-6115-7584</orcidid><orcidid>https://orcid.org/0000-0002-9516-8863</orcidid><orcidid>https://orcid.org/0000-0003-0792-6247</orcidid><orcidid>https://orcid.org/0000-0002-7278-4831</orcidid></search><sort><creationdate>202101</creationdate><title>Characterization of wound microbes in epidermolysis bullosa: Results from the epidermolysis bullosa clinical characterization and outcomes database</title><author>Levin, Laura E. ; 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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. Methods A retrospective analysis of 739 wound cultures from 158 patients from 13 centers between 2001 and 2018. Results Of 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. Conclusions SA and PA were the most commonly isolated bacteria from wounds. 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subjects Anti-Bacterial Agents - therapeutic use
Antibiotic resistance
Antibiotics
Bacteria
Canada
Cell culture
cultures
Epidermolysis bullosa
Epidermolysis Bullosa - complications
Epidermolysis Bullosa - drug therapy
Genetic disorders
Humans
Methicillin
microbes
Microbiota
Microorganisms
Mupirocin
Pediatrics
resistance
Retrospective Studies
Skin diseases
Squamous cell carcinoma
Staphylococcal Infections - drug therapy
Staphylococcus aureus
Staphylococcus infections
Streptococcus infections
wound
Wounds
title Characterization of wound microbes in epidermolysis bullosa: Results from the epidermolysis bullosa clinical characterization and outcomes database
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