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The widespread use of topical antimicrobials enriches for resistance in Staphylococcus aureus isolated from Atopic Dermatitis patients

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The widespread use of topical antimicrobials enriches for resistance in Staphylococcus aureus isolated from Atopic Dermatitis patients. / Harkins, C. P.; McAleer, M. A.; Bennett, D.; McHugh, M.; Fleury, O. M.; Pettigrew, K. A.; Oravcová, K.; Parkhill, J.; Proby, C. M.; Dawe, R. S.; Geoghegan, J. A.; Irvine, A. D.; Holden, M. T. G.

In: British Journal of Dermatology, Vol. Early View, 24.07.2018.

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Harvard

Harkins, CP, McAleer, MA, Bennett, D, McHugh, M, Fleury, OM, Pettigrew, KA, Oravcová, K, Parkhill, J, Proby, CM, Dawe, RS, Geoghegan, JA, Irvine, AD & Holden, MTG 2018, 'The widespread use of topical antimicrobials enriches for resistance in Staphylococcus aureus isolated from Atopic Dermatitis patients', British Journal of Dermatology, vol. Early View. https://doi.org/10.1111/bjd.16722

APA

Harkins, C. P., McAleer, M. A., Bennett, D., McHugh, M., Fleury, O. M., Pettigrew, K. A., ... Holden, M. T. G. (2018). The widespread use of topical antimicrobials enriches for resistance in Staphylococcus aureus isolated from Atopic Dermatitis patients. British Journal of Dermatology, Early View. https://doi.org/10.1111/bjd.16722

Vancouver

Harkins CP, McAleer MA, Bennett D, McHugh M, Fleury OM, Pettigrew KA et al. The widespread use of topical antimicrobials enriches for resistance in Staphylococcus aureus isolated from Atopic Dermatitis patients. British Journal of Dermatology. 2018 Jul 24;Early View. https://doi.org/10.1111/bjd.16722

Author

Harkins, C. P. ; McAleer, M. A. ; Bennett, D. ; McHugh, M. ; Fleury, O. M. ; Pettigrew, K. A. ; Oravcová, K. ; Parkhill, J. ; Proby, C. M. ; Dawe, R. S. ; Geoghegan, J. A. ; Irvine, A. D. ; Holden, M. T. G. / The widespread use of topical antimicrobials enriches for resistance in Staphylococcus aureus isolated from Atopic Dermatitis patients. In: British Journal of Dermatology. 2018 ; Vol. Early View.

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@article{a8dfb9a20f2f4c419658bda7556c3100,
title = "The widespread use of topical antimicrobials enriches for resistance in Staphylococcus aureus isolated from Atopic Dermatitis patients",
abstract = "Background: Carriage rates of Staphylococcus aureus on affected skin in atopic dermatitis (AD) are approximately 70 Increasing disease severity during flares and overall disease severity correlate with increased burden of S. aureus. Treatment in AD therefore often targets S. aureus, with topical and systemic antimicrobials.Objectives: To determine if antimicrobial sensitivities and genetic determinants of resistance differed in S. aureus isolates from the skin of children with AD compared with healthy child nasal carriers.Methods:  In this case‐control study, we compared S. aureus isolates from children with AD (n=50) attending a hospital dermatology department to nasal carriage isolates from children without skin disease (n=49) attending a hospital emergency department for non‐infective conditions. Using whole genome sequencing we generated a phylogenetic framework for the isolates based on variation in the core genome, then compared antimicrobial resistance phenotype and genotypes between disease groups.Results and conclusions:  S. aureus from cases and controls had on average similar numbers of phenotypic resistances per isolate. Case isolates differed in their resistance patterns, with Fusidic acid resistance (FusR) being significantly more frequent in AD (p=0.009). The genetic basis of FusR also differentiated the populations, with chromosomal mutations in fusA predominating in AD (p=0.049). Analysis revealed that FusR evolved multiple times and via multiple mechanism in the population. Carriage of plasmid derived qac genes, which have been associated with reduced susceptibility to antiseptics, was 8 times more frequent in AD (p=0.016). The results suggest strong selective pressure drives the emergence and maintenance of specific resistances in AD.",
author = "Harkins, {C. P.} and McAleer, {M. A.} and D. Bennett and M. McHugh and Fleury, {O. M.} and Pettigrew, {K. A.} and K. Oravcov{\'a} and J. Parkhill and Proby, {C. M.} and Dawe, {R. S.} and Geoghegan, {J. A.} and Irvine, {A. D.} and Holden, {M. T. G.}",
note = "This work was supported by grants from the Wellcome Trust (104241/z/14/z to C.P.H., and 098731/z/11/z to St Andrews University Bioinformatics Unit), and the Chief Scientists Office (SIRN10 to M.T.G.H.).",
year = "2018",
month = "7",
day = "24",
doi = "10.1111/bjd.16722",
language = "English",
volume = "Early View",
journal = "British Journal of Dermatology",
issn = "0007-0963",
publisher = "Wiley-Blackwell",

}

RIS (suitable for import to EndNote) - Download

TY - JOUR

T1 - The widespread use of topical antimicrobials enriches for resistance in Staphylococcus aureus isolated from Atopic Dermatitis patients

AU - Harkins, C. P.

AU - McAleer, M. A.

AU - Bennett, D.

AU - McHugh, M.

AU - Fleury, O. M.

AU - Pettigrew, K. A.

AU - Oravcová, K.

AU - Parkhill, J.

AU - Proby, C. M.

AU - Dawe, R. S.

AU - Geoghegan, J. A.

AU - Irvine, A. D.

AU - Holden, M. T. G.

N1 - This work was supported by grants from the Wellcome Trust (104241/z/14/z to C.P.H., and 098731/z/11/z to St Andrews University Bioinformatics Unit), and the Chief Scientists Office (SIRN10 to M.T.G.H.).

PY - 2018/7/24

Y1 - 2018/7/24

N2 - Background: Carriage rates of Staphylococcus aureus on affected skin in atopic dermatitis (AD) are approximately 70 Increasing disease severity during flares and overall disease severity correlate with increased burden of S. aureus. Treatment in AD therefore often targets S. aureus, with topical and systemic antimicrobials.Objectives: To determine if antimicrobial sensitivities and genetic determinants of resistance differed in S. aureus isolates from the skin of children with AD compared with healthy child nasal carriers.Methods:  In this case‐control study, we compared S. aureus isolates from children with AD (n=50) attending a hospital dermatology department to nasal carriage isolates from children without skin disease (n=49) attending a hospital emergency department for non‐infective conditions. Using whole genome sequencing we generated a phylogenetic framework for the isolates based on variation in the core genome, then compared antimicrobial resistance phenotype and genotypes between disease groups.Results and conclusions:  S. aureus from cases and controls had on average similar numbers of phenotypic resistances per isolate. Case isolates differed in their resistance patterns, with Fusidic acid resistance (FusR) being significantly more frequent in AD (p=0.009). The genetic basis of FusR also differentiated the populations, with chromosomal mutations in fusA predominating in AD (p=0.049). Analysis revealed that FusR evolved multiple times and via multiple mechanism in the population. Carriage of plasmid derived qac genes, which have been associated with reduced susceptibility to antiseptics, was 8 times more frequent in AD (p=0.016). The results suggest strong selective pressure drives the emergence and maintenance of specific resistances in AD.

AB - Background: Carriage rates of Staphylococcus aureus on affected skin in atopic dermatitis (AD) are approximately 70 Increasing disease severity during flares and overall disease severity correlate with increased burden of S. aureus. Treatment in AD therefore often targets S. aureus, with topical and systemic antimicrobials.Objectives: To determine if antimicrobial sensitivities and genetic determinants of resistance differed in S. aureus isolates from the skin of children with AD compared with healthy child nasal carriers.Methods:  In this case‐control study, we compared S. aureus isolates from children with AD (n=50) attending a hospital dermatology department to nasal carriage isolates from children without skin disease (n=49) attending a hospital emergency department for non‐infective conditions. Using whole genome sequencing we generated a phylogenetic framework for the isolates based on variation in the core genome, then compared antimicrobial resistance phenotype and genotypes between disease groups.Results and conclusions:  S. aureus from cases and controls had on average similar numbers of phenotypic resistances per isolate. Case isolates differed in their resistance patterns, with Fusidic acid resistance (FusR) being significantly more frequent in AD (p=0.009). The genetic basis of FusR also differentiated the populations, with chromosomal mutations in fusA predominating in AD (p=0.049). Analysis revealed that FusR evolved multiple times and via multiple mechanism in the population. Carriage of plasmid derived qac genes, which have been associated with reduced susceptibility to antiseptics, was 8 times more frequent in AD (p=0.016). The results suggest strong selective pressure drives the emergence and maintenance of specific resistances in AD.

U2 - 10.1111/bjd.16722

DO - 10.1111/bjd.16722

M3 - Article

VL - Early View

JO - British Journal of Dermatology

JF - British Journal of Dermatology

SN - 0007-0963

ER -

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