Temporal and racial differences associated with atopic dermatitis Staphylococcus aureus and encoded virulence factors

Joseph A. Merrimanc, Elizabeth A. Mueller, Michael P. Cahill, Lisa A. Beck, Amy S. Paller, Jon M. Hanifin, Peck Y. Ong, Lynda Schneider, Denise C. Babineau, Gloria David, Alexandre Lockhart, Keli Artis, Donald Y.M. Leung, Patrick M. Schlievert

Research output: Contribution to journalArticlepeer-review

23 Scopus citations


Atopic dermatitis (AD) is an inflammatory skin condition strongly associated with Staphylococcus aureus colonization and infection. S. aureus strains shift in populations in ~10-year intervals depending on virulence factors. Shifts in S. aureus virulence factors may in part explain the racial differences observed in the levels of prevalence and severity of AD. AD S. aureus isolates collected from 2011 to 2014 (103 isolates) and in 2008 (100 isolates) were examined for the prevalence of genes encoding superantigens (SAgs). The strains from 2011 to 2014 were obtained from AD patients as a part of the National Institute of Allergy and Infectious Diseases (NIAID) Atopic Dermatitis Research Network (ADRN). The prevalence of SAg genes was investigated temporally and racially. The enterotoxin gene cluster (EGC) was more prevalent in the 2011-2014 AD isolates than in the 2008 AD isolates. The prevalences of virulence factor genes were similar in European American (EA) and Mexican American (MA) patients but differed in 6 of 22 SAg genes between EA and African American (AA) or MA and AA isolates; notably, AA isolates lacked tstH, the gene encoding toxic shock syndrome toxin 1 (TSST-1). The presence of tstH and sel-p (enterotoxin-like P) was associated with decreased clinical severity and increased blood eosinophils, respectively. The EGC is becoming more prevalent, consistent with the previously observed 10 years of cycling of S. aureus strains. Race-specific S. aureus selection may account for differences in virulence factor profiles. The lack of TSST-1-positive (TSST-1+) AD S. aureus in AA is consistent with the lack of AAs acquiring TSST-1-associated menstrual toxic shock syndrome (TSS).

Original languageEnglish (US)
Article numbere00295-16
Issue number6
StatePublished - Nov 1 2016


  • Atopic dermatitis
  • Clonal groups
  • Phenotype
  • Race
  • Staphylococcus aureus
  • Superantigens

ASJC Scopus subject areas

  • Microbiology
  • Molecular Biology


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