According to Epidermolysis Bullosa News, staph infections are increasingly common in the wounds or blisters of patients with epidermolysis bullosa (EB). In fact, an analysis of these lesions showed that most had a Staphylococcus aureus infection. Because this could affect treatment options and treatment resistance, it is important for doctors to understand how and why these infections occur, and how to better treat them. Read the full findings in Pediatric Dermatology.
Overall, there are over 30 types of Staphylococcus, though Staphylococcus aureus tends to cause the most infections. According to the Mayo Clinic:
Staph infections are caused by staphylococcus bacteria, types of germs commonly found on the skin or in the nose of even healthy individuals. Most of the time, these bacteria cause no problems or result in relatively minor skin infections.
However, if the infection gets deeper into the skin, blood, joints, or other areas of the body, it can be painful or even deadly. In patients with weakened immune systems or other conditions, the infections are often more severe. Patients with EB are at a higher risk of severe infections because of their fragile and delicate skin. Unfortunately, patients are subject to increased injury, skin tearing, or painful blistering. Because of this, they are also at risk of other infections, such as staph infections, or squamous cell carcinoma (SCC).
For this study, researchers wanted to understand what type of bacteria is commonly found in EB lesions. Additionally, researchers sought to understand the link between SCC and these bacteria. The analyzed 739 wound cultures sourced from the EB Clinical Characterization and Outcomes Database (EBCCOD). This database centers around patients within North America. 96% of patients had a bacterial infection, with 72% of patients having more than one bacteria present. Common bacteria included Staphylococcus aureus, Pseudomonas aeruginosa, and Streptococcus pyogenes, although others were also present.
One issue that researchers discovered is that around 50% of patients with Staphylococcus aureus had an antibiotic-resistant strain. Because of this, patients do not respond well to topical or oral antibiotic treatment. This calls for additional research and treatment options in the future.
Researchers also discovered SCC in 23 patients, most of whom had staph infections. Staphylococcus aureus and Pseudomonas aeruginosa were the most common staph infections in SCC. Ultimately, this shows that these microbes are highly associated with worse outcomes.
Epidermolysis Bullosa (EB)
Defective KRT5 or KRT14 genes cause epidermolysis bullosa (EB), a group of connective tissue diseases. An estimated 1 in every 50,000 American births has EB. Overall, the genetic disorder causes delicate skin. When introduced to friction or rubbing, EB results in moderate-to-severe skin blistering. In milder cases, patients may only experience external blistering and lesions. However, in severe cases, patients may also develop blistering internally within the digestive and respiratory systems.
There are three main forms of EB. First, epidermolysis bullosa simplex (EBS) causes widespread skin blistering, as well as thickened skin on the palms and soles. Next, junctional epidermolysis bullosa (JEB) causes thin skin and large blisters. If these ulcerate, JEB can become life-threatening. Finally, dystrophic epidermolysis bullosa (DEB) primarily occurs on the hands and feet. DEB is often associated with a heightened risk of SCC. Additional signs and symptoms include:
- Itchy, painful skin
- Thickened nails
- Scalp blistering and scarring
- Hair loss
- Dental problems, such as tooth decay
- Difficulty swallowing