Microbial eczema (ME) is characterized by frequent recurrence. Colonization of microorganisms on ME-affected skin areas is hundreds of times greater than in healthy individuals. The choice of therapy for relapsed chronic ME remains challenging because of the rapid emergence of microbial resistance to multiple antibacterial agents.

OBJECTIVE

To assess the microbiome on the affected skin during combined treatment.

MATERIAL AND METHODS

The study was supported by the Local Ethics Committee and approved by the Scientific Council of the Pirogov Russian National Research Medical University. Patients’ parents signed informed consent to participate in the study, anonymized analysis, and publication of results. Patients (n=78) aged 1-13 years (median 7 years) were randomized into two groups: Group 1 patients received percutaneous blood irradiation with low-energy helium-neon laser in addition to standard of care; Group 2 patients received treatment of lesions with cold atmospheric plasma (CAP). Before and after therapy, bacteriological examination of smears from the surface of the lesions was performed.

RESULTS

In all patients, the growth of S. aureus was shown in skin surface samples: in 12.8% of patients, as pure culture; in the rest of patients, in association with 2-4 microorganisms (S. epidermidis — 69.2%, Streptococcus spp. — 59.0%, Candida spp. — 39.7%). In 25.6% of S. aureus isolates were MRSA. Complete resolution of the skin lesions was achieved in 67% of cases when CAP was included in the complex treatment and only in 7.7% of patients when laser therapy was added. A significant improvement in the skin lesions was achieved in 74.4% of Group 1 patients and 33% of Group 2 patients. CAB as a part of the combination treatment resulted in complete eradication of S. aureus (including MRSA strain), while the combination with laser eradicated S. aureus in 85% of patients and MRSA only in 30% of cases. In Group 1, colonization by Streptococci and S. epidermidis persisted in 5.9 and 16.4% of cases, respectively; in Group 2, no Streptococcus isolates were revealed, and S. epidermidis was detected in 5.2% of patients. Both treatments have been shown to be effective against Candida spp.

CONCLUSIONS

Biophysical techniques based combinations in the therapy of ME can achieve complete eradication of Candida spp., almost complete eradication of S. aureus (including MRSA), providing superior efficacy.