Staphylococcal skin colonization in children with atopic dermatitis: prevalence, persistence, and transmission of toxigenic and nontoxigenic strains

J Infect Dis. 1992 Jun;165(6):1064-8. doi: 10.1093/infdis/165.6.1064.


Staphylococcal skin colonization is a common feature of atopic dermatitis (AD) in adults. Little is known about prevalence and persistence of staphylococci in children. Forty-one AD children (mean age, 70 months) and 41 age-matched controls were studied. S. aureus was isolated from 38 AD patients (93%; 32% of controls, P less than .001) and 37% of AD patients (5% of controls, P less than .001) harbored toxigenic (enterotoxins, toxic shock syndrome toxin) S. aureus strains. No individual biotype prevailed. On follow-up (mean interval, 9 months), 70% of S. aureus strains were reisolated. Nasal and cutaneous S. aureus strains were identical in 73% of AD patients (7% of controls, P less than .001), reflecting increased self-contamination. Identical staphylococcal strains in AD children and their mothers were observed in 38% (S. aureus) and 16% (coagulase-negative strains; P less than .001). The prevalence of staphylococcal colonization in AD children is comparable to that in adults. High rates of self-contamination, transmission to contacts, and prevalence of toxigenic strains in AD children may have clinical and epidemiologic implications.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Bacterial Toxins*
  • Bacteriophage Typing
  • Carrier State / microbiology*
  • Child
  • Child, Preschool
  • Dermatitis, Atopic / microbiology*
  • Enterotoxins / biosynthesis
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Male
  • Nasal Mucosa / microbiology
  • Prevalence
  • Skin / microbiology*
  • Staphylococcal Skin Infections / microbiology*
  • Staphylococcal Skin Infections / transmission
  • Staphylococcus aureus / classification
  • Staphylococcus aureus / growth & development*
  • Staphylococcus aureus / isolation & purification
  • Staphylococcus aureus / pathogenicity
  • Superantigens*
  • Virulence


  • Bacterial Toxins
  • Enterotoxins
  • Superantigens
  • enterotoxin F, Staphylococcal