Hannah M Singer1, Laura E Levin2, Maria C Garzon2,3, Christine T Lauren2,3, Paul J Planet4, Nicole W Kittler2, Susan Whittier5, Kimberly D Morel2,3. 1. College of Physicians and Surgeons, Columbia University, New York, NY, USA. 2. Department of Dermatology, College of Physicians and Surgeons, Columbia University, New York, NY, USA. 3. Department of Pediatrics, College of Physicians and Surgeons, Columbia University, New York, NY, USA. 4. Division of Infectious Disease, Children's Hospital of Philadelphia, Philadelphia, PA, USA. 5. Department of Pathology and Cell Biology, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
Abstract
BACKGROUND/ OBJECTIVES: Many patients with epidermolysis bullosa (EB) require intensive daily wound care and individualized treatment plans. Understanding patient's home skin care routines and emerging antibiotic resistance patterns in EB wounds is necessary to optimize treatment recommendations. The objective was to identify patterns of antimicrobial resistance in EB wounds and characterize patient's home practices of skin care and bathing. METHODS: This was an observational study of 23 children with EB at an outpatient pediatric dermatology practice in New York City from 2012 to 2014. Information on individual bathing and skin care practices and wound cultures was collected as part of routine examinations and an institutional review board-approved antibiogram protocol. RESULTS: Sixty wound cultures were collected from 23 patients. Eleven organisms were isolated, most commonly methicillin-susceptible Staphylococcus aureus, methicillin-resistant S. aureus, Streptococcus species, and Pseudomonas aeruginosa. Six patients (26%) were colonized with methicillin-resistant S. aureus. Over the course of the study, 13 patients (56%) were found to have mupirocin-resistant S. aureus. More than half of participants reported mupirocin or bacitracin use. Fewer than half indicated that they regularly used dilute bleach or dilute vinegar as part of their bathing routine. CONCLUSION: Numerous organisms, including resistant bacteria, are known to colonize the wounds of individuals with EB. Mupirocin resistance was prevalent and more than half of the participants reported its use. Testing for mupirocin resistance may be considered for certain patients. These observations may help guide questions for future longitudinal multicenter studies with the goal of optimizing EB wound care recommendations.
BACKGROUND/ OBJECTIVES: Many patients with epidermolysis bullosa (EB) require intensive daily wound care and individualized treatment plans. Understanding patient's home skin care routines and emerging antibiotic resistance patterns in EB wounds is necessary to optimize treatment recommendations. The objective was to identify patterns of antimicrobial resistance in EB wounds and characterize patient's home practices of skin care and bathing. METHODS: This was an observational study of 23 children with EB at an outpatient pediatric dermatology practice in New York City from 2012 to 2014. Information on individual bathing and skin care practices and wound cultures was collected as part of routine examinations and an institutional review board-approved antibiogram protocol. RESULTS: Sixty wound cultures were collected from 23 patients. Eleven organisms were isolated, most commonly methicillin-susceptible Staphylococcus aureus, methicillin-resistant S. aureus, Streptococcus species, and Pseudomonas aeruginosa. Six patients (26%) were colonized with methicillin-resistant S. aureus. Over the course of the study, 13 patients (56%) were found to have mupirocin-resistant S. aureus. More than half of participants reported mupirocin or bacitracin use. Fewer than half indicated that they regularly used dilute bleach or dilute vinegar as part of their bathing routine. CONCLUSION: Numerous organisms, including resistant bacteria, are known to colonize the wounds of individuals with EB. Mupirocin resistance was prevalent and more than half of the participants reported its use. Testing for mupirocin resistance may be considered for certain patients. These observations may help guide questions for future longitudinal multicenter studies with the goal of optimizing EB wound care recommendations.
Authors: Gustavo Henrique Rodrigues Vale de Macedo; Gabrielle Damasceno Evangelista Costa; Elane Rodrigues Oliveira; Glauciane Viera Damasceno; Juliana Silva Pereira Mendonça; Lucas Dos Santos Silva; Vitor Lopes Chagas; José Manuel Noguera Bazán; Amanda Silva Dos Santos Aliança; Rita de Cássia Mendonça de Miranda; Adrielle Zagmignan; Andrea de Souza Monteiro; Luís Cláudio Nascimento da Silva Journal: Pathogens Date: 2021-02-02
Authors: Laura E Levin; Leila H Shayegan; Anne W Lucky; Kristen P Hook; Anna L Bruckner; James A Feinstein; Susan Whittier; Christine T Lauren; Elena Pope; Irene Lara-Corrales; Karen Wiss; Catherine C McCuaig; Julie Powell; Lawrence F Eichenfield; Moise L Levy; Lucia Diaz; Sharon A Glick; Amy S Paller; Harper N Price; John C Browning; Kimberly D Morel Journal: Pediatr Dermatol Date: 2020-11-28 Impact factor: 1.588