Effect of a lotion containing the heat-treated probiotic strain Lactobacillus johnsonii NCC 533 on Staphylococcus aureus colonization in atopic dermatitis

Figures & data

Figure 1 Swab and scrub wash sampling techniques.

Table 1 Baseline demographics and disease characteristics

Baseline characteristics	Population 1	Population 2
Patients, n	31	21
Age, years (SD)	33.5 (11.6)	33.0 (12.5)
Female, n (%)	16 (51.6)	7 (33.3)
Male/female ratio	0.94	2
Atopic dermatitis
Severity, n (%)
Mild	2 (6.5)	0 (0.0)
Moderate	25 (80.6)	18 (85.7)
Severe	4 (12.9)	3 (14.3)
Atopic dermatitis duration, years (SD)	27.1 (14.2)	26.5 (14.7)
Target lesion SCORAD score (SD)	30.5 (8.2)	32.2 (7.0)
Contralateral lesions, n (%)	20 (64.5)	15 (71.4)
Location of target lesions, n (%)
Ankle	1 (3.2)	1 (4.8)
Arm	1 (3.2)	0 (0.0)
Elbow	14 (45.2)	11 (52.4)
Forearm	7 (22.6)	4 (19.0)
Knee	3 (9.7)	2 (9.5)
Thigh	1 (3.2)	1 (4.8)
Tibia	3 (9.7)	1 (4.8)
Trunk	1 (3.2)	1 (4.8)
Location of contralateral lesions, n (%)	N=20	N=15
Elbow	9 (45.0)	8 (53.3)
Forearm	6 (30.0)	4 (26.7)
Knee	2 (10.0)	1 (6.7)
Thigh	1 (5.0)	1 (6.7)
Tibia	2 (10.0)	1 (6.7)

Notes: Population 1= enrolled patients; Population 2= patients who were found to be carriers of S. aureus at the start of the study and presented with clinically visible lesions on Day 8.

Abbreviations: SD, standard deviation; SCORAD, SCORing Atopic Dermatitis.

Table 2 Presence and concentration of Staphylococcus aureus on the target lesion at baseline (Population 1)

Sampling method	Sampling	Quantification method	Presence of S. aureus (%)	Concentration of S. aureus (Log10 CFU/cm^2)
				Mean±SD	Median (Min, Max)
Swab (Group 1)	First	Culture	8/16 (50.0)	2.16±2.25	0.73 (0.31, 6.21)
		PCR	8/15 (53.3)	1.56±2.03	0.57 (0.01, 5.93)
	Second	Culture	8/16 (50.0)	1.71±1.85	0.81 (0.31, 5.87)
		PCR	8/16 (50.0)	1.42±1.93	0.37 (0.01, 5.69)
Scrub wash (Group 2)	First	Culture	9/15 (60.0)	2.30±1.65	2.20 (0.61, 5.25)
		PCR	10/15 (66.7)	1.92±1.40	2.03 (0.31, 3.90)
	Second	Culture	9/15 (60.0)	2.31±1.72	1.91 (0.31, 5.02)
		PCR	10/15 (66.7)	2.00±1.44	2.19 (0.31, 4.35)

Notes: In the absence of S. aureus detection, the missing value was replaced by the limit of quantification of the method (culture: 10 CFU/mL; PCR: 5 CFU/mL). Population 1= enrolled patients.

Abbreviations: CFU, colony forming units; SD, standard deviation; Min, minimum; Max, maximum; PCR, polymerase chain reaction.

Figure 2 Repeatability (first and second sampling) of Staphylococcuss aureus sampling (A) and quantification (B) methods at Day 1 for load determination (Log₁₀ CFU/cm²) in target atopic dermatitis lesions.

Notes: Results are presented for both quantification methods (A) and both sampling methods (B). Pearson’s correlation coefficient ≥0.83.
Abbreviations: CFU, colony forming units; PCR, polymerase chain reaction.

Figure 3 Staphylococcus aureus load evolution between Days 8 and 28 in target atopic dermatitis lesions treated with heat-treated Lactobacillus johnsonii lotion vs contralateral lesions untreated or treated with patient’s usual moisturizer (n=15).

Notes: Bacterial sampling and quantification were performed by swab and quantitative polymerase chain reaction. The difference between S. aureus load in target vs contralateral lesions at Day 28 was significant (p<0.05 using Wilcoxon signed rank test).
Abbreviations: CFU, colony forming units; PCR, polymerase chain reaction.

Figure 4 Change in skin microbiota composition between Days 8 and 28 in target atopic dermatitis lesions treated with heat-treated Lactobacillus johnsonii lotion.

Figure 5 Box plots show local objective SCORAD evolution between Days 8 and 28 in target atopic dermatitis lesions treated with heat-treated Lactobacillus johnsonii lotion. Statistical analysis was performed using the paired t-test.

Notes: ◊ indicates mean values and ○ indicates outlier values.
Abbreviation: SCORAD, SCORing Atopic Dermatitis.