Detection of Secondary Bacterial Contaminants in Patients with Eczema

Abstract

Abstract:Background: Eczema is an inflammatory skin reaction in which a lot of external and internal factors acting singly or in combination to induce the condition. Eczema leads to damage of the normal defense mechanisms of the skin. Therefore, eczematous skin becomes favorable site for bacterial contamination.Objectives: The study aims at identifying the types of bacteria that commonly infect eczematous skin. It is also aimed at assessment of age factor and its relation to the type of bacteria that commonly infect various eczematous skins. Thirdly, it is aimed at identifying the bacterial sensitivity to antibiotics to determine the appropriate treatment.Patients & methods: The study subjects were patients suffering from various types of eczema involved in cross-sectional study. Eighty-eight patients were collected. The patients were attending the dermatology clinics at Al-Yarmook Teaching Hospital and Al-Kindy Teaching Hospital. The study period was from September 2001 till February 2002. Identification of bacterial isolates is performed by 3 ways: morphological identification, biochemical tests and Api tests. Bacterial sensitivity to antibiotics was performed by Kirby-Bauer diffusion method. Statistical analysis was performed by utilizing Pearson Chi-Square test.Results: One hundred sixty bacterial specimens were taken from the study subjects. Statistical analysis proved a significant association between the types of eczema and the types of bacterial isolates (Pearson χ² = 38.728, df = 18, P value = 0.003).Staphylococcus aureus was mainly sensitive to neomycin (100%). Staphylococcus epidermidis was mainly sensitive to neomycin (94.9%) and vancomycin (100%). Escherichia coli was mainly sensitive to streptomycin (86.7%) and amikacin (86.7%). Klebsiella pneumoniae was mainly sensitive to neomycin (83.3%) and amikacin (86.7%). Enterobactor cloacae was mainly sensitive to amikacin (100%). Proteus mirabilis was mainly sensitive to neomycin (100%) and amikacin (100%). Pseudomonas aeruginosa was mainly sensitive to neomycin (85%), streptomycin (85%) and amikacin (85%). All bacterial types were highly resistant to penicillin G, ampicillin, amoxicillin and cloxacillin.Conclusions: Gram-positive bacteria especially staphylococcus aureus and staphylococcus epidermidis commonly infect eczematous skin more than Gram-negative bacteria. Staphylococcus aureus is a common invader of atopic eczema and discoid eczema, this phenomenon stresses its pathogenic role in these 2 types of eczema and to a lesser extent in all damaged eczematous skin. All bacterial types have shown high resistance to penicillins whilst they are vulnerable to aminoglycosides especially neomycin and amikacin.Key words: Eczema, Bacteria, Contaminants.