As I am feverishly working on a supplemental manuscript on gram-negative bacilli and their increasing resistance to broad-spectrum antibiotics used in the critically ill with nosocomial infections, I stumbled on an enlightening article (see: http://news.nationalgeographic.com/news/2007/02/070206-skin-microbes.html) about the diverse coat of microbes blanketing our most outer regions.1 Bacteria and their treatments have always reminded me of the colorful and ever-changing world of fashion. Scientific article with titles such as “The New β-Lactamases,”2 “Emerging Bacterial Enzyme Targets,”3 and European “Trends in Ventilator-Associated Pneumonia”4 bring to mind sleek pneumococcal organisms modeling their finest, evolutionary genes in late summer for the masses to adopt during the subsequent winter season. As microorganisms change over time, whether through resistance, changes in transmission, or natural selection; so do the types of treatments used to treat the infections they cause. Therefore, what is “in” this season with regard to pathogens and treatments in a given geographical region may be passe by next.
A recent study by Martin J. Blaser and other infectious disease researchers at New York University School of Medicine implicated >240 distinct microorganisms on the forearms of 6 healthy subjects. For each subject in this study, their “coat” of microbes appeared to be as unique as their sense of style and no 2 subjects had an identical matrix or “robe” of microorganisms. While some overlap of microbes existed among subjects, for the most part there was “tremendous variation” in the types of organisms. Furthermore, repeated tests demonstrated that subjects’ microbes change with time,1 akin to how our hair or clothing styles change from year to year (or season to season, that is…you should have seen my hair weave a few years back). By the way, does anyone still have those polyester tops, platform shoes, and bell bottoms stashed in their closets?
Changes in skin flora may be related a host of elements ranging from the type of fabric that brushes up against our skin to the chemicals in the shampoos and detergents we use. The big idea behind Blaser and colleagues research was to determine if there are specific skin microbes associated with inflammatory conditions (eg, eczema). Of course, improved understanding of skin flora will allow for the development of more effective therapies.1
So, each one of has our very own unique “robe” of microbes that alters with time. As a lifelong sufferer of eczema and psoriasis, I look forward to additional exploration of these pathogens and their effects on inflammatory conditions. As an aside, beyond the apparel we don and the numerous products we lather on our skin, my gut is telling me that diet, stress, pollution, medication, and other environmental elements also influence our “microbiologic sense of fashion” at any given season. Lastly, while I feel that there are some individuals with skin conditions that necessitate pharmacotherapy, there are probably less potentially toxic methods to consider. Perhaps some day our decendents will read about our microbial fashion sense and grimace. How fascinating it would be to have Marie Antoinette’s “coat of microbes” to analyze and critique today!
1. Harder B. Humans wear diverse “wardrobe” of skin microbes, study finds. February 6, 2007. National Geographic News Web site. Available at: http://news.nationalgeographic.com/news/2007/02/070206-skin-microbes.html. Accessed March 2007.
2. Jacoby GA, Munoz-Price LS. The new beta-lactamases. N Engl J Med. 2005;352:380-391.
3. Su Z, Honek JF. Emerging bacterial enzyme targets. Curr Opin Investig Drugs. 2007;8:140-149.
4. Zuschneid I, Schwab F, Geffers C, Behnke M, Ruden H, Gastmeier P. Trends in Ventilator-Associated Pneumonia Rates Within the German Nosocomial Infection Surveillance System (KISS). Infect Control Hosp Epidemiol. 2007;28:314-318.