Atopic Dermatitis and Staphylococcus aureus: A Complex Relationship with Therapeutic Implications

A strong association has been established between Staphylococcus aureus and atopic dermatitis (AD). Although the exact mechanism of this relationship remains unclear, many studies have characterized differences in S. aureus between individuals with AD and unaffected controls. Patients with AD have higher cutaneous colonization with S. aureus, with increased bacterial density correlating with AD severity. S. aureus virulence factors can exacerbate the immune dysregulation seen in AD. Consequently, AD treatments have shifted to focus on S. aureus as a therapeutic target, including skin bacterial transplant and probiotics. In addition, traditional mainstays of AD treatment, such as corticosteroids, have been found to induce changes in the cutaneous microbiota and S. aureus levels, underscoring its importance in the pathogenesis of AD. Nonpharmacological treatments have been investigated as well, without definitive results. Both bacteriotherapy and nonpharmacological treatments merit continued study on their effects on S. aureus colonization and role in the treatment of AD.