Hand eczema and temporal variation of Staphylococcus aureus clonal complexes: A prospective observational study.

ABSTRACT Background Hand eczema (HE) is frequently colonized with Staphylococcus aureus (S. aureus); however, its role in the pathogenesis of HE is poorly understood. Objective To investigate temporal variation of S. aureus sub-types, i.e. Clonal Complex (CC) types on hands and relate to nose colonization and severity in a cohort of HE-patients. Methods Prospectively identify S. aureus from the hands and nose of 50 adult HE-patients and 50 controls at five visits over three weeks. Results S. aureus was identified on the hands in 23 patients (46%) at two or more visits, and in one control once. Of colonized HE-patients, 78% had the same S. aureus CC-type over time. Twenty-one patients had the same S. aureus CC-type on the hands and in the nose. Persistent colonization was strongly related to increased disease severity. Limitations The relatively small S. aureus culture-positive population. Conclusion Temporal stability of S. aureus CC-type and high occurrence of identical sub-type on the hands and in the nose imply S. aureus colonization in HE to be of a more permanent nature. Together with the finding that persistent colonization and HE severity are clearly related, our results indicate that S. aureus may contribute to the perpetuating course of HE.