Staphylococcus Aureus Colonization In Adults' Atopic Dermatitis Treament With Topical 0.1% Tacrolimus Cream

Objective: as many pathological factors are known to contribute to atopic dermatitis (AD), the colony of Staphylococcus aureus in lesional areas of AD is one of the important correlated factors. The purpose of this study was to determine the effect of tacrolimus on Staphylococcus aureus in lesional areas of AD by investigating the density colonization before and after treatment with topical 0.1% tacrolimus cream. Additionally, we assessed the relationship in Staphylococcus aureus colonization and clinical signs of AD.Methods: we enrolled 21 patients with AD, who visited our department of dermatology from October 2005 to april 2006 and were diagnosed with AD using the criteria of Hanifin and Rajka. They were treated with 0.1% tacrolimus cream twice daily for 3 weeks. Staphylococcus aureus colonization was measured by the tape method. Evaluations were performed at weeks 0 (baseline), 1, 2 and 3. In order to correlate Staphylococcus aureus colonization density at each site with parameters of treatment efficacy, we performed clinical grading based on the lesional score of the SCORAD index. Statistical analysis was performed by SPSS 11.5 for Winows. Statistical comparison was performed using pair samples t-Test. Correlation analysis was made using Pearson correlation.Results: When patients were administered tacrolimus cream twice daily, their Staphylococcus aureus colonization density was 31563.16±39637.92 before treatment, 6788.75±9586.66 after 1 week of treatment, 3715.50±8850.03 after 2 weeks and 647.46±772.70 after 3 weeks, resulting in a progressive and significant decrease (p＜0.001) with treatment. The lesional score of the SCORAD index at weeks 0 (baseline), 1, 2 and 3 was 12.17±2.95, 8.03±2.16, 5.32±1.63和3.51±1.59, respectively. These also result in a progressive and significant decrease (p＜0.001) with treatment. There wasn't a significant correlation between Staphylococcus aureus colonization density and SCORAD index (p＞0.05). Conclusion: When the clinical grading based on the lesional score of the SCORAD index showed a significant decreasing after topical application of 0.1% tacrolimus cream on the lesion of patients with AD, the Staphylococcus aureus colonization density was also reduced at the same period. Because there wasn't a significant correlation between Staphylococcus aureus colonization density and SCORAD index, it is conceivable that the decrease in Staphylococcus aureus colonization density was a result of the improvement in skin barrier function, which can be attributed to the immunosuppressive effect.