High genetic diversity of Staphylococcus aureus strains colonizing patients with epidermolysis bullosa

Patients with the blistering disease, epidermolysis bullosa (EB), frequently suffer from chronic wounds that become colonized by pathogenic bacteria, such as Staphylococcus aureus. To determine S.similar to aureus colonization rates in patients with EB, swabs were collected from the anterior nares, throats and wounds of 52 Dutch patients with EB. Swabs were also collected from nares and throats of 13 healthcare workers who occasionally meet the sampled patients with EB. All EB patients with chronic wounds and 75% of the patients without chronic wounds were colonized with S.similar to aureus. In contrast, 39% of the sampled healthcare workers were colonized with S.similar to aureus. Typing revealed a high degree of genetic diversity of 184 collected S.similar to aureus isolates. Autoinoculation of S.similar to aureus in individual patients with EB was shown to occur frequently, whereas transmission of S.similar to aureus between patients with EB is apparently rare. There was no evidence for S.similar to aureus transmission between patients with EB and healthcare workers.