المحددات البكترولوجية والمناعية لمرضى التهاب الجلد الاستشرائي في محافظة كربلاء المقدسة

Bacteriological and Immunological Determinants of Atopic Dermatitis Patients in Holy Kerbala Province

Abstract

Atopic dermatitis (AD) is a multifaceted disease that results from a complex relationship between genetic and environmental factors. Both these variables will form the role of the skin barrier infection and the immunological response of predisposed patients. The current study was conducted to evaluate the correlation between serum level of some immunological parameters such as Interleukin-5 (IL-5), Interleukin-13 (IL-13) and immunoglobulin E (IgE) with skin bacterial infection and severity of AD in patients.
Eighty cases including 50 patients (20 males and 30 females) with history of AD that diagnosed according to the clinical symptoms and by examining physicians were enrolled in the present study. In addition 30 healthy cases were selected as a control group in Kerbala province, during the period from December 2019 to July 2020. The procedures of present study were performed at the laboratories of Al- Hussein Teaching Hospital, when distinguished of AD according to the age and gender. Data obtained from the current study showed that the percentage of AD in females was (60%) more than in males (40%), in addition the highest percentage of infection with AD (60%) was in the patients of 5-15 age category while the lowest infection percentage (18%) was in the 26-35 age group compared to other age group.
When cultured 130 skin swab samples from 50 patients with AD (50 sample from lesional loci and 50 sample from surrounding area of lesional loci) and 30 sample from control group , that diagnosed by biochemical test ,Vitek system, and PCR technique. 31 isolates (91%) of Gram positive bacteria represented by Staphylococcus. aureus (70.5% ) were the commonest isolated genera followed by Bacillus spp (8.8%), Kokuria rhizophila(5.9%), Staphylococcus. epidermidis(2.9%), Staphylococcus heamolyticus(2.9%), but only 3 isolates (8.8%) were Gram negative bacteria that represented by Pseudomonas stutzeri from lesional loci of AD patients. In addition Gram positive bacteria included S. aureus , S .epidermidis and S. heamolyticus were isolated from surrounding loci of AD lesional area in high percentage compared to Gram negative bacteria, one isolates ( 3% ) that represented by P .stutzeri. Furthermore the profile of bacterial which is isolated from skin of control group were represented by low percentage of S. aureus 4 isolates (20% ) with high percentage of normal flora 16 isolates (80%) S. epidermidis.
Blood samples were collected also form the patients to determine the serum level of IgE, IL-5 and IL-13 in all studied groups .The results revealed a significant increase in the patient groups (378.2) (13.3) and (23.6) respectively compared to the control group that reach to (65.1) (2.2) and (2.06).
In addition results of white blood cells count showed a significant increase (P < 0.05) in patients with AD in the females (8.48) and males (7.80) compared to males (6.86) and females (7.10) in the control group respectively. And an a significant variant of differential WBCs count ,the mean of neutrophils cell showed significant increase in females (51.72) compared to males (46.21).In addition the lymphocytes cell were significant increase in males (37.42) in compared to females (36.02) but is non-significant increase in males compared to control group. The eosinophils and basophils show significant increase (P < 0.05) in the both sex compared to control group .
It can be concluded from these results that the relationship between the variance of certain immunological parameters in the AD patients with the disease and development of bacterial infection .