Atopic Dermatitis (AD), Impetigo, Scabies
Conditions
Keywords
Staphylococcus aureus, Streptococcus pyogenes, Nasal colonization, Impetiginization, Antimicrobial resistance, MRSA
Brief summary
This prospective observational study will evaluate the microbiological profile of secondary bacterial infection and nasal colonization in participants with scabies or atopic dermatitis. Bacteria isolated from impetiginized skin lesions and nasal swabs will be compared, and antimicrobial susceptibility patterns will be assessed. Healthy participants without an inflammatory skin disease or signs of infection will provide nasal swabs as a control group. Patients will be followed on days 7 and 14 to assess clinical response and related clinical measures.
Detailed description
Participants with dermatologist-confirmed scabies or atopic dermatitis and active impetiginized skin lesions will undergo clinical assessment and microbiological sampling. A superficial swab will be obtained from the infected skin lesion and a nasal swab will be obtained from the nasal vestibules. Healthy controls will undergo nasal sampling only. Cultures will be evaluated for Staphylococcus aureus, Streptococcus pyogenes, and other bacterial isolates. Antimicrobial susceptibility testing will be performed according to European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidance. Skin and nasal isolates will be compared at the species level and by antimicrobial resistance profile. Clinical data include age, sex, disease duration, comorbidities, recent treatments, itch severity using a 0-10 visual analog scale, and lesion morphology, location, number, and excoriation. Patients will be contacted on days 7 and 14 to assess clinical response, new lesion development, change in itch severity, treatment adherence, and local or systemic adverse events.
Interventions
None listed
Sponsors
Istanbul Medeniyet University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
Yes
Inclusion criteria
* Scabies group: dermatologist-confirmed scabies and an active impetiginized skin lesion. * Atopic dermatitis group: dermatologist-confirmed atopic dermatitis and an active impetiginized skin lesion. * Healthy control group: no inflammatory skin disease or clinical signs of infection. * Written informed consent (and appropriate parent/guardian permission when applicable).
Exclusion criteria
* Systemic or topical antibiotic use within the previous 14 days. * Active nasal infection or nasal symptoms. * History of nasal surgery or anatomic nasal deformity. TEST DRAFT NOTE: The source protocol contains wording that may conflict with inclusion of healthy controls; the final eligibility text must be reconciled with the ethics-approved protocol before release.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Concordance of bacterial species between impetiginized skin lesion and nasal cultures | At baseline (enrollment) | Among participants in the scabies and atopic dermatitis groups with paired evaluable skin and nasal cultures, concordance will be defined as isolation of the same bacterial species from both anatomical sites. Species-level agreement will be summarized and evaluated using Cohen's kappa coefficient. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Bacterial profile of impetiginized skin lesions | At baseline (enrollment) | The number and proportion of lesion cultures yielding Staphylococcus aureus, Streptococcus pyogenes, other bacteria, mixed growth, or no bacterial growth will be summarized. |
| Nasal Staphylococcus aureus carriage across study groups | At baseline (enrollment) | The number and proportion of participants with nasal Staphylococcus aureus carriage will be summarized for the scabies, atopic dermatitis, and healthy control groups. |
| Antimicrobial susceptibility and resistance profile of bacterial isolates | At baseline (enrollment) | Antimicrobial susceptibility results, including methicillin resistance among Staphylococcus aureus isolates and susceptibility to the antibiotics included in the laboratory panel, will be summarized for skin and nasal isolates. |
| Clinical response at day 14 | 14 days after enrollment | Clinical response will be categorized as complete remission, partial response, no change, or worsening. Associations with bacterial species, methicillin resistance, antimicrobial resistance, nasal carriage, and skin-nasal concordance will be explored. |
| Development of new skin lesions during follow-up | Through 14 days after enrollment | The occurrence of new lesions during the 14-day follow-up period will be recorded. |
Countries
Turkey (Türkiye)
Contacts
CONTACTTEST CONTACT - REPLACE
PRINCIPAL_INVESTIGATORTEST INVESTIGATOR - REPLACE
TEST AFFILIATION - REPLACE
Outcome results
None listed