Association Between Staphylococcus Aureus Colonization and Pediatric Atopic Dermatitis: A Systematic Review and Meta-Analysis

Author(s): Phoomphut Sangaphunchai [1]; Chawan Kritsanaviparkporn [1]; Arucha Treesirichod (corresponding author) [1] Introduction Atopic dermatitis is an inflammatory skin condition characterized by poorly defined erythema, edema, and vesicles in acute [...]
Background: Atopic dermatitis is a chronic inflammatory skin condition common in early childhood. Acute exacerbation is frequently associated with Staphylococcus aureus colonization. Aims and Objectives: This study aims to explore the relationship between S. aureus skin and nasal colonization with pediatric atopic dermatitis. Methods: A systematic review and meta-analysis were conducted by comparing atopic dermatitis patients aged ≤18 years and nondiseased controls. A random-effects model was used to obtain the pooled prevalence and odds ratio of S. aureus colonization at eczematous skin, nonlesional skin, and nasal cavity. Subgroup analyses for colonization with methicillin-resistant S. aureus were also evaluated. Results: A total of 2,670 cases and 1,224 controls from 26 studies were included in the meta-analysis. S. aureus colonization at eczematous skin and nasal cavity is significantly higher in atopic dermatitis compared to control with odds ratios of 10.55 (95 confidence interval [CI]; 4.85-22.92, P < .001) and 2.38 (nasal cavity; 95 CI; 1.46-3.90, P < .001), respectively. The pooled prevalence of skin and nasal colonization were 55.0 (eczematous skin; 95 CI; 38.3-71.7), 23.3 (nonlesional skin; 95 CI; 12.6-33.9), and 56.3 (95 CI; 43.2-69.4), respectively. Methicillin-resistant S. aureus strain was obtained from the nares and eczematous skin with rates of 11.6 (95 CI; 6.5-16.7) and 8.5 (95 CI; 4.3-12.8), respectively. Conclusion: Children with atopic dermatitis are more prone to skin and nasal colonization by S. aureus compared to nondiseased individuals. Keywords: Adolescent, atopic dermatitis, childhood, colonization, Staphylococcus aureus