Characterization of wound microbes in epidermolysis bullosa: Results from the epidermolysis bullosa clinical characterization and outcomes database

Laura E. Levin; Leila H. Shayegan; Anne W. Lucky; Kristen P. Hook; Anna L. Bruckner; James A. Feinstein; Susan Whittier; Christine T. Lauren; Elena Pope; Irene Lara-Corrales; Karen Wiss; Catherine C. McCuaig; Julie Powell; Lawrence F. Eichenfield; Moise L. Levy; Lucia Diaz; Sharon A. Glick; Amy S. Paller; Harper N. Price; John C. Browning; Kimberly D. Morel

doi:10.1111/pde.14444

Characterization of wound microbes in epidermolysis bullosa: Results from the epidermolysis bullosa clinical characterization and outcomes database

Laura E. Levin^*, Leila H. Shayegan, Anne W. Lucky, Kristen P. Hook, Anna L. Bruckner, James A. Feinstein, Susan Whittier, Christine T. Lauren, Elena Pope, Irene Lara-Corrales, Karen Wiss, Catherine C. McCuaig, Julie Powell, Lawrence F. Eichenfield, Moise L. Levy, Lucia Diaz, Sharon A. Glick, Amy S. Paller, Harper N. Price, John C. BrowningKimberly D. Morel

^*Corresponding author for this work

Dermatology

Research output: Contribution to journal › Article › peer-review

21 Scopus citations

Abstract

Background/Objectives: Patients with epidermolysis bullosa (EB) require care of wounds that are colonized or infected with bacteria. A subset of EB patients are at risk for squamous cell carcinoma, and bacterial-host interactions have been considered in this risk. The EB Clinical Characterization and Outcomes Database serves as a repository of information from EB patients at multiple centers in the United States and Canada. Access to this resource enabled broad-scale analysis of wound cultures. Methods: A retrospective analysis of 739 wound cultures from 158 patients from 13 centers between 2001 and 2018. Results: Of 152 patients with a positive culture, Staphylococcus aureus (SA) was recovered from 131 patients (86%), Pseudomonas aeruginosa (PA) from 56 (37%), and Streptococcus pyogenes (GAS) from 34 (22%). Sixty-eight percent of patients had cultures positive for methicillin-sensitive SA, and 47%, methicillin-resistant SA (18 patients had cultures that grew both methicillin-susceptible and methicillin-resistant SA at different points in time). Of 15 patients with SA-positive cultures with recorded mupirocin susceptibility testing, 11 had mupirocin-susceptible SA and 6 patients mupirocin-resistant SA (2 patients grew both mupirocin-susceptible and mupirocin-resistant SA). SCC was reported in 23 patients in the entire database, of whom 10 had documented wound cultures positive for SA, PA, and Proteus species in 90%, 50%, and 20% of cases, respectively. Conclusions: SA and PA were the most commonly isolated bacteria from wounds. Methicillin resistance and mupirocin resistance were reported in 47% and 40% of patients tested, respectively, highlighting the importance of ongoing antimicrobial strategies to limit antibiotic resistance.

Original language	English (US)
Pages (from-to)	119-124
Number of pages	6
Journal	Pediatric dermatology
Volume	38
Issue number	1
DOIs	https://doi.org/10.1111/pde.14444
State	Published - Jan 1 2021

Funding

This work was supported by the Epidermolysis Bullosa Research Partnership and EB Medical Research Foundation [#CU16-2131]. This study was supported by NIH/NCATS Colorado CTSA Grant Number UL1 TR002535. Contents are the authors’ sole responsibility and do not necessarily represent official NIH views during the conduct of the study The following individuals provided significant research support for this study: Kathleen Peoples, University of Colorado Denver; Bret Augsburger, Cincinnati Children’s Hospital; Hannah Singer, MD, Columbia University Vagelos College of Physicians and Surgeons; Jenna Borok, MD, Allison Han, MD, and Nicola Natsis, BA, University of California San Diego; and Sarah H. Schwartz, Dell Children’s Medical Center. We would like to thank Yuan (Vivian) Zhang, MS, and Codruta Chiuzan, PhD, of the Department of Biostatistics, Columbia University Irving Medical Center, for their statistical support. We are grateful and indebted to the patients and their families who participated in this study. We would also like to thank the Pediatric Dermatology Research Alliance for facilitating collaborative multicenter research. This work was supported by the Epidermolysis Bullosa Research Partnership and EB Medical Research Foundation [#CU16‐2131]. This study was supported by NIH/NCATS Colorado CTSA Grant Number UL1 TR002535. Contents are the authors’ sole responsibility and do not necessarily represent official NIH views during the conduct of the study

Keywords

cultures
epidermolysis bullosa
microbes
resistance
wound

ASJC Scopus subject areas

Dermatology
Pediatrics, Perinatology, and Child Health

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10.1111/pde.14444

Cite this

Levin, L. E., Shayegan, L. H., Lucky, A. W., Hook, K. P., Bruckner, A. L., Feinstein, J. A., Whittier, S., Lauren, C. T., Pope, E., Lara-Corrales, I., Wiss, K., McCuaig, C. C., Powell, J., Eichenfield, L. F., Levy, M. L., Diaz, L., Glick, S. A., Paller, A. S., Price, H. N., ... Morel, K. D. (2021). Characterization of wound microbes in epidermolysis bullosa: Results from the epidermolysis bullosa clinical characterization and outcomes database. Pediatric dermatology, 38(1), 119-124. https://doi.org/10.1111/pde.14444

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title = "Characterization of wound microbes in epidermolysis bullosa: Results from the epidermolysis bullosa clinical characterization and outcomes database",

abstract = "Background/Objectives: Patients with epidermolysis bullosa (EB) require care of wounds that are colonized or infected with bacteria. A subset of EB patients are at risk for squamous cell carcinoma, and bacterial-host interactions have been considered in this risk. The EB Clinical Characterization and Outcomes Database serves as a repository of information from EB patients at multiple centers in the United States and Canada. Access to this resource enabled broad-scale analysis of wound cultures. Methods: A retrospective analysis of 739 wound cultures from 158 patients from 13 centers between 2001 and 2018. Results: Of 152 patients with a positive culture, Staphylococcus aureus (SA) was recovered from 131 patients (86%), Pseudomonas aeruginosa (PA) from 56 (37%), and Streptococcus pyogenes (GAS) from 34 (22%). Sixty-eight percent of patients had cultures positive for methicillin-sensitive SA, and 47%, methicillin-resistant SA (18 patients had cultures that grew both methicillin-susceptible and methicillin-resistant SA at different points in time). Of 15 patients with SA-positive cultures with recorded mupirocin susceptibility testing, 11 had mupirocin-susceptible SA and 6 patients mupirocin-resistant SA (2 patients grew both mupirocin-susceptible and mupirocin-resistant SA). SCC was reported in 23 patients in the entire database, of whom 10 had documented wound cultures positive for SA, PA, and Proteus species in 90%, 50%, and 20% of cases, respectively. Conclusions: SA and PA were the most commonly isolated bacteria from wounds. Methicillin resistance and mupirocin resistance were reported in 47% and 40% of patients tested, respectively, highlighting the importance of ongoing antimicrobial strategies to limit antibiotic resistance.",

keywords = "cultures, epidermolysis bullosa, microbes, resistance, wound",

author = "Levin, {Laura E.} and Shayegan, {Leila H.} and Lucky, {Anne W.} and Hook, {Kristen P.} and Bruckner, {Anna L.} and Feinstein, {James A.} and Susan Whittier and Lauren, {Christine T.} and Elena Pope and Irene Lara-Corrales and Karen Wiss and McCuaig, {Catherine C.} and Julie Powell and Eichenfield, {Lawrence F.} and Levy, {Moise L.} and Lucia Diaz and Glick, {Sharon A.} and Paller, {Amy S.} and Price, {Harper N.} and Browning, {John C.} and Morel, {Kimberly D.}",

note = "Publisher Copyright: {\textcopyright} 2020 Wiley Periodicals LLC.",

year = "2021",

month = jan,

day = "1",

doi = "10.1111/pde.14444",

language = "English (US)",

volume = "38",

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journal = "Pediatric dermatology",

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number = "1",

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Levin, LE, Shayegan, LH, Lucky, AW, Hook, KP, Bruckner, AL, Feinstein, JA, Whittier, S, Lauren, CT, Pope, E, Lara-Corrales, I, Wiss, K, McCuaig, CC, Powell, J, Eichenfield, LF, Levy, ML, Diaz, L, Glick, SA, Paller, AS, Price, HN, Browning, JC & Morel, KD 2021, 'Characterization of wound microbes in epidermolysis bullosa: Results from the epidermolysis bullosa clinical characterization and outcomes database', Pediatric dermatology, vol. 38, no. 1, pp. 119-124. https://doi.org/10.1111/pde.14444

TY - JOUR

T1 - Characterization of wound microbes in epidermolysis bullosa

T2 - Results from the epidermolysis bullosa clinical characterization and outcomes database

AU - Levin, Laura E.

AU - Shayegan, Leila H.

AU - Lucky, Anne W.

AU - Hook, Kristen P.

AU - Bruckner, Anna L.

AU - Feinstein, James A.

AU - Whittier, Susan

AU - Lauren, Christine T.

AU - Pope, Elena

AU - Lara-Corrales, Irene

AU - Wiss, Karen

AU - McCuaig, Catherine C.

AU - Powell, Julie

AU - Eichenfield, Lawrence F.

AU - Levy, Moise L.

AU - Diaz, Lucia

AU - Glick, Sharon A.

AU - Paller, Amy S.

AU - Price, Harper N.

AU - Browning, John C.

AU - Morel, Kimberly D.

PY - 2021/1/1

Y1 - 2021/1/1

N2 - Background/Objectives: Patients with epidermolysis bullosa (EB) require care of wounds that are colonized or infected with bacteria. A subset of EB patients are at risk for squamous cell carcinoma, and bacterial-host interactions have been considered in this risk. The EB Clinical Characterization and Outcomes Database serves as a repository of information from EB patients at multiple centers in the United States and Canada. Access to this resource enabled broad-scale analysis of wound cultures. Methods: A retrospective analysis of 739 wound cultures from 158 patients from 13 centers between 2001 and 2018. Results: Of 152 patients with a positive culture, Staphylococcus aureus (SA) was recovered from 131 patients (86%), Pseudomonas aeruginosa (PA) from 56 (37%), and Streptococcus pyogenes (GAS) from 34 (22%). Sixty-eight percent of patients had cultures positive for methicillin-sensitive SA, and 47%, methicillin-resistant SA (18 patients had cultures that grew both methicillin-susceptible and methicillin-resistant SA at different points in time). Of 15 patients with SA-positive cultures with recorded mupirocin susceptibility testing, 11 had mupirocin-susceptible SA and 6 patients mupirocin-resistant SA (2 patients grew both mupirocin-susceptible and mupirocin-resistant SA). SCC was reported in 23 patients in the entire database, of whom 10 had documented wound cultures positive for SA, PA, and Proteus species in 90%, 50%, and 20% of cases, respectively. Conclusions: SA and PA were the most commonly isolated bacteria from wounds. Methicillin resistance and mupirocin resistance were reported in 47% and 40% of patients tested, respectively, highlighting the importance of ongoing antimicrobial strategies to limit antibiotic resistance.

AB - Background/Objectives: Patients with epidermolysis bullosa (EB) require care of wounds that are colonized or infected with bacteria. A subset of EB patients are at risk for squamous cell carcinoma, and bacterial-host interactions have been considered in this risk. The EB Clinical Characterization and Outcomes Database serves as a repository of information from EB patients at multiple centers in the United States and Canada. Access to this resource enabled broad-scale analysis of wound cultures. Methods: A retrospective analysis of 739 wound cultures from 158 patients from 13 centers between 2001 and 2018. Results: Of 152 patients with a positive culture, Staphylococcus aureus (SA) was recovered from 131 patients (86%), Pseudomonas aeruginosa (PA) from 56 (37%), and Streptococcus pyogenes (GAS) from 34 (22%). Sixty-eight percent of patients had cultures positive for methicillin-sensitive SA, and 47%, methicillin-resistant SA (18 patients had cultures that grew both methicillin-susceptible and methicillin-resistant SA at different points in time). Of 15 patients with SA-positive cultures with recorded mupirocin susceptibility testing, 11 had mupirocin-susceptible SA and 6 patients mupirocin-resistant SA (2 patients grew both mupirocin-susceptible and mupirocin-resistant SA). SCC was reported in 23 patients in the entire database, of whom 10 had documented wound cultures positive for SA, PA, and Proteus species in 90%, 50%, and 20% of cases, respectively. Conclusions: SA and PA were the most commonly isolated bacteria from wounds. Methicillin resistance and mupirocin resistance were reported in 47% and 40% of patients tested, respectively, highlighting the importance of ongoing antimicrobial strategies to limit antibiotic resistance.

KW - cultures

KW - epidermolysis bullosa

KW - microbes

KW - resistance

KW - wound

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Characterization of wound microbes in epidermolysis bullosa: Results from the epidermolysis bullosa clinical characterization and outcomes database

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