Microbiology of infected pustular psoriasis lesions

BACKGROUND: Bacterial infections can occur in lesions of pustular psoriasis (PP). The objective of this study was to establish the aerobic and anaerobic microbiology of secondarily infected PP. METHODS: A retrospective 10-year review was carried out of clinical and microbiology laboratory records from patients with secondarily infected PP lesions, whose specimens of infected sites were processed for the presence of aerobic and anaerobic bacteria. RESULTS: Bacterial growth was noted in 23 specimens. Aerobic or facultative anaerobic bacteria only were present in 12 patients (52%), anaerobic bacteria only in four (17%), and mixed anaerobic-aerobic flora was present in seven (30%). Thirty-six isolates were recovered (1.6 per specimen), 23 aerobic or facultative bacteria and 13 strict anaerobes. The predominant aerobic and facultative bacteria were Staphylococcus aureus (15 isolates), Group D Enterococcus (two isolates), and Escherichia coli (two isolates). The predominant anaerobes were Peptostreptococcus spp. (six isolates) and Bacteroides fragilis group, Propionibacterium acnes, and pigmented Prevotella spp. in two each. Single bacterial isolates were recovered in 14 patients (61%), 11 of which were S. aureus. Nineteen of the organisms isolated from 18 patients (78%) produced the enzyme beta-lactamase. S. aureus was isolated from all body sites. Organisms that resided in the mucous membranes close to the lesions predominated in these infections. Enteric Gram-negative rods and Bacteroides fragilis group predominated in lesions on the legs and buttocks. Group A beta-hemolytic streptococci, pigmented Prevotella, and Fusobacterium spp. were most frequently recovered in lesions of the hand. CONCLUSIONS: The polymicrobial etiology of secondarily infected PP lesions and the association of bacterial flora with the anatomic site of the lesions were demonstrated.     

Microbiology of infected poison ivy dermatitis

We report the aerobic and anaerobic microbiology of secondarily infected poison ivy dermatitis. The study involved retrospective review of clinical and microbiology laboratory records of patients with secondarily infected poison ivy lesions. Bacterial growth was noted in 33 specimens. Aerobic or facultative anaerobic bacteria only were present in 18 (55%) patients, anaerobic bacteria only in seven (21%), and mixed anaerobic-aerobic bacteria in eight (24%). Forty-five isolates were recovered (1.4 per specimen): 27 aerobic or facultative anaerobic bacteria, and 18 strict anaerobes. The predominant aerobic and facultative anaerobic bacteria were Staphylococcus aureus (13 isolates) and group A beta-haemolytic streptococci (six). The predominant anaerobes were Peptostreptococcus spp. (seven isolates), pigmented Prevotella and Porphyromonas spp. (four) and Fusobacterium spp. (two). Single bacterial isolates were recovered in 18 (55%) patients, eight of which were S. aureus. Nineteen of the organisms isolated from 16 (48%) patients produced the enzyme beta-lactamase. Organisms that resided in the mucous membranes close to the lesions predominated in those infections. Enteric gram-negative rods and Bacteroides fragilis group predominated in leg and buttock lesions. Group A beta-haemolytic streptococci, pigmented Prevotella and Porphyromonas and Fusobacterium spp. were most frequently recovered from lesions of the finger, face and neck. The polymicrobial aetiology of secondarily infected poison ivy lesions, and the association of bacterial flora with the anatomical site of the lesions, are demonstrated.     

Microbiology of infected epidermal cysts

Specimens from 231 epidermal cyst abscesses were inoculated on media supportive for growth of aerobic and anaerobic bacteria. Of these, 192 yielded bacterial growth. Aerobic or facultative bacteria only were recovered in 84 specimens (44%), anaerobic bacteria only in 57 specimens (30%), and mixed aerobic and anaerobic bacteria in 51 specimens (26%). A total of 315 isolates (162 anaerobes and 153 aerobes) were recovered. An average of 0.8 aerobic or facultative isolates per infected cyst were recovered, and this number was unrelated to the cysts' anatomic sites. However, the number of anaerobic bacteria varied; they were isolated more frequently in perirectal (1.5 isolates per specimen), vulvovaginal (1.4), and head (1.1) infections, and less frequently in trunk (0.7) and extremities (0.4) infections. The predominant aerobic or facultative bacteria were Staphylococcus aureus (81 isolates), group A streptococcus (9 isolates), and Escherichia coli (7 isolates). The predominant anaerobic organisms were Peptostreptococcus species (85 isolates) and Bacteroides species (55 isolates, including 12 Bacteroides melaninogenicus and 9 Bacteroides fragilis groups). The study highlights the polymicrobial nature and predominance of anaerobes in cyst abscesses in the perirectal, vulvovaginal, and head areas.     

Aerobic and anaerobic microbiology of chronic venous ulcers

Abstract
Background The role of bacteria in the pathogenesis of chronic venous leg ulcers (CVLU) is unclear. The objective of the study was to establish the aerobic and anaerobic bacteriology of CVLU.
Methods A retrospective review was carried out of the clinical and microbiological laboratory records obtained from patients with CVLU. Microorganisms were grown from 43 specimens obtained from 41 patients.
Results Aerobic or facultative bacteria alone were present in 18 (42%) specimens, anaerobic bacteria only in three (7%), and mixed aerobic–anaerobic flora in 22 (51%).
In total, there were 97 isolates, 64 aerobic or facultative and 33 anaerobic, an average of 2.3 isolates per specimen (1.5 aerobes and 0.8 anaerobes). The predominant aerobic organisms were Staphylococcus aureus (26 isolates), group D streptococci (5), and Escherichia coli (5). The predominant anaerobes were Peptostreptococcus spp. (15), Bacteroides fragilis group (6), Propionibacterium acnes (4), and Prevotella spp. (3).
Conclusions CVLU have a polymicrobial aerobic–anaerobic flora.     

Microbiology of Nonbullous Impetigo

Abstract: Our objective was to establish the aerobic and anaerobic microbiology of nonbullous impetigo (Nl) in children. We used a retrospective review of clinical microbiology laboratory and patients'records. Specimens were obtained from 40 patients with Nl lesions and showed bacteriai growth. Aerobic or facultative anaerobic bacteria only were present in 24 patients (60%), strict anaerobic bacteria only in 5 patients (12.5%), and mixed anaerobic-aerobic flora was present in 11 patients (27.5%). Sixty-four isolates were recovered (1.6 per specimen): 43 aerobic or facultative, and 21 anaerobic. The predominant aerobic and facultative bacteria were Staphylococcus aureus (29 isolates). Group A beta hemolytic streptococcus (GABHS) (13 Isolates), and Escherichia coli (1 isolate). The predominant anaerobes were Peptostreptococcus spp. (12), pigmented Prevotella spp. (5), Fusobacterium spp. (2), and Bacteroides fragilis (1). Single bacterial isolates were recovered in 17 patients (42.5%), 13 of which were S. aureus. S. aureus alone or mixed with GABHS or Peptostreptococcus spp. were isolated from all body sites. Mixed flora of Peptostreptococcus spp. with Prevotella spp. or Fusobacterium spp. was mostly found in infections of the head and neck, while E. coli mixed with B. fragills and Peptostreptococcus spp. were isolated from one infection of the buttocks area. Thirty-three organisms isolated from 32 patients (80%) produced the enzyme beta-lactamase. This study demonstrates the polymicrobial aerobic-anaerobic microbiology of Nl lesions.     

Microbiology of infected hemangiomas in children

Bacterial infections are a common complication of hemangiomas in children. The objective of this study was to establish the aerobic and anaerobic microbiology of infected hemangiomas. A retrospective 8-year review of clinical and microbiology laboratory records from patients with secondarily infected hemangiomas was carried out. Specimens from infected sites were processed for the presence of aerobic and anaerobic bacteria. Bacterial growth was present in 32 of 38 specimens. Aerobic bacteria alone were recovered in 12 infected hemangiomas (37.5%), anaerobic bacteria alone in 8 (33%), and mixed aerobic and anaerobic flora in 12 (37.5%). A total of 80 isolates (47 aerobes and 33 anaerobes) were recovered, giving an average of 2.5 isolates per specimen (1.5 aerobes and 1.0 anaerobes). The highest number of isolates were recovered in infections of the perineum (3.7 per site) and the legs (2.8 per site). The predominant aerobic isolates were Staphylococcus aureus, group A beta-hemolytic streptococci, and Enterobacteriaceae. The predominant anaerobes were Peptostreptococcus sp., gram-negative bacilli, and Fusobacterium sp. Organisms that belong to the mucous membranes close to the lesions predominated in infections next to those membranes. The polymicrobial etiology of secondarily infected hemangiomas and the association of bacterial flora with the anatomic site of the lesions is thereby demonstrated.     

MICROBIOLOGY OF INFECTED ATOPIC DERMATITIS

Background. Bacterial infections occur frequently in lesions of atopic dermatitis (AD). The objectives of the study were to establish the aerobic and anaerobic microbiology of secondarily infected AD. Methods. A retrospective review was carried out of clinical and microbiology laboratory records and of data obtained from patients with secondarily infected AD lesions, whose specimens of infected sites were processed for the presence of aerobic and anaerobic bacteria. Results. Bacterial growth was noted in 41 specimens. Aerobic or facultative anaerobic bacteria only were present in 15 patients (36%), anaerobic bacteria only in eight (20%), and mixed anaerobic-aerobic flora was present in 18 (44%). Seventy- two isolates were recovered (1.8 per specimen), 34 aerobic or facultative bacteria, 35 strict anaerobes, and three Candida sp. The predominant aerobic and facultative bacteria were Staphylococcus aureus (12 isolates). Group A beta hemolytic streptococcus in five isolates, and Escherichia coli in four. The predominant anaerobes were peptostreptococcus spp. (13 isolates), pigmented Prevotella and Porphyromonas spp. in eight, and Fusobacterium spp. in four isolates. Single bacterial isolates were recovered in 14 patients (34%), seven of which were S. aureus. Twenty-one of the organisms isolated from 16 patients (39%) produced the enzyme beta-lactamase. Organisms that resided in the mucous membranes close to the lesions predominated in these infections. Enteric gram-negative rods and bacteroides fragilis group predominated in lesions on legs and buttocks. Group A beta-hemolytic streptococci, pigmented Prevotella, and Porphyromonas and Fusobacterium spp. were most frequently recovered in lesions of the finger, scalp, face, and neck. Conclusions. The polymicrobial etiology of secondarily infected AD lesions and the association of bacterial flora with the anatomic site of the lesions are demonstrated.     

Aerobic and anaerobic bacterial flora of crural ulcers

In a group of 600 patients treated in the Metropolitan Dermatological Hospital in Warsaw bacteriological examination were carried out of swabs from the untreated crural ulcers. In 95% of these cultures growth of pathological aerobic organisms was obtained. Coagulase-positive staphylococci (St. aureus) and Gram-negative bacteria (Pseudomonas aeruginosa, Proteus vulgaris, Enterobacter sp and E. coli) prevailed. In 27% of cases the cultured strains were resistant to the generally available antibiotics. In the second group in 70 patients no growth of anaerobes exclusively was noted. Pathological aerobes and anaerobes in the same case were found in 45% of cultures. In the remaining ones pathogenic aerobes were present with a similar frequency as in the preceding group. Of the anaerobes the most frequently cultured species were Gram-negative bacteria such as Bacteroides melaninogenicus, Bacteroides sp, and Bacteroides fragilis. Among pathogenic anerobic cocci Peptostreptococcus and Peptococcus were most frequent. In 2 cases spore-forming anaerobic bacteria (Clostridium perfringens) were obtained. Forty-eight percent of anaerobes were resistant to the commonly used antibiotics.     

Aerobic and Anaerobic Microbiology of Necrotizing Fasciitis in Children

Abstract: Specimens obtained from eight children with necrotizing fasciitis (NF) were cultured for aerobic and anaerobic bacteria. A total of 21 isolates were recovered, 13 anaerobic and 8 aerobic or facultatives. The facultative organism Streptococcus pyogenes was present alone in two (25%) instances, and mixed aerobic and anaerobic bacteria were isolated in six (75%). The predominant isolates were Peptostreptococcus spp. (6 isolates, including 3 Peptostreptococcus magnus ). S. pyogenes (4), Bacteroides fragilis group (3), Clostridium perfringens (2), Escherichia coli (2), and Prevotella spp. (2). Organisms similar to the ones isolated from the NF aspirates were recovered in the blood of all patients except one. These included S. pyogenes (3 isolates). B. fragilis group (2), E. coli (1), and P. magnus (1) and Clostridium perfringens (1). All patients underwent surgical fasciotomy, and four required skin grafting. Antimicrobials were administered to all children. Despite extensive resection and intense supportive therapy, three patients died from sepsis accompanied by shock acidosis and disseminated intravascular coagulation. These findings illustrate the polymicrobial aerobic-anaerobic flora of NF in children.     

Anaerobic flora in trophic ulcers in leprosy patients

Material from 108 trophic ulcers from leprosy cases were studied bacteriologically. 4 cases showed growth of pure anaerobes and 69 showed mixed growth of aerobic and anaerobic bacteria. The predominant anaerobes were Fusobacteria (41), anaerobic cocci (30) and Bacteroides (25). Clostridia were isolated only in 10 cases. Metronidazole, chloramphenicol, penicillin and ampicillin were found effective against anaerobes in in-vitro studies.     

The microbiology of infected and noninfected leg ulcers

BACKGROUND: A clinical study was undertaken to investigate and compare specifically the aerobic and anaerobic microbiology of infected and noninfected leg ulcers. METHODS: Leg ulcers, defined as being infected on the basis of clinical signs, were swab sampled and investigated for aerobic and anaerobic microorganisms using stringent isolation and identification techniques. RESULTS: Two hundred and twenty isolates were cultured from 44 infected leg ulcers, in comparison with 110 isolates from 30 noninfected leg ulcers. Statistical analysis indicated a significantly greater mean number of anaerobic bacteria per infected ulcer (particularly Peptostreptococcus spp. and Prevotella spp.) in comparison with the noninfected ulcer group (2.5 vs. 1.3, respectively) (P < 0.05). Also, anaerobes represented 49% of the total microbial composition in infected leg ulcers compared with 36% in noninfected leg ulcers. The mean numbers of aerobes per wound in the two ulcer groups were not statistically different (P > 0.05). The study failed to demonstrate a clear correlation between commonly implicated facultative pathogens and wound infection. The isolation rate of Pseudomonas aeruginosa was generally low and, although Staphylococcus aureus was a frequent isolate in both wound types, it was more prevalent in noninfected leg ulcers. CONCLUSIONS: This study has demonstrated the complex aerobic-anaerobic microflora which exists in leg ulcers, the prevalence of anaerobes in infected wounds, and a poor correlation between the presence of specific aerobic pathogens and wound infection. In view of these findings, the role of microbial synergistic interactions in the pathogenesis of chronic wound infection may be of greater clinical importance than the isolated involvement of any specific potential pathogen.     

The role of microorganisms in diaper dermatitis.

A quantitative microbiological survey of multiple sites in the diaper area in 40 normal infants and 100 infants with various forms of diaper dermatitis showed (1) no significant differences between normal infants and those with common chafing form of diaper dermatitis except for a low number of Staphylococcus aureus organisms in 50% of those with chafing dermatitis compared to no S aureus in normals; (2) S aureus occurred in high numbers in every case of atopic dermatitis and was frequently found at much lower levels in psoriasis, seborrheic dermatitis, and chafing dermatitis; (3) Candida albicans occurred in 80% of cases clinically diagnosed as moniliasis localized to the diaper area and in 33% of those suspected of Candida infection with dissemination beyond the diaper area, while C albicans was found in only five of 145 culture sites in 40 normal infants.     

Anaerobes in genitourinary infections in men.

Urethral and sub-preputial swabs from 150 men were examined. There was a strong association between the isolation of anaerobic bacteria, particularly Bacteroides spp, and a clinical diagnosis of balanoposthitis, non-specific urethritis (NSU), or both. Aerobic bacteria formed the predominant flora in 28 healthy controls whereas anaerobes were predominant in specimens from 79 patients with balanoposthitis, from 24 with NSU, and from 19 with both. Bacteroides spp were the commonest isolates in all patient groups; B asaccharolyticus, B melaninogenicus ss intermedius, B ureolyticus, and B bivius were the most common species. The results obtained with the two swabs were identical except that Gardnerella vaginalis was isolated from the urethral swab only in five patients.     

Microbiological aspects of diaper dermatitis

BACKGROUND: The microbiological basis of diaper dermatitis is not clearly elucidated, although a better knowledge of microbial colonisation can be of importance with regard to an adequate treatment. OBJECTIVE: To investigate the relevance of candida sp. and Staphylococcus aureus colonisation in diaper dermatitis and to determine the correlation between the extent of colonisation and the severity of disease. METHODS: Growth of candida sp. and S. aureus in the perianal, inguinal and oral regions was determined by positive/negative and semi-quantitative analysis in an open, multi-centre (n = 3) study. Forty-eight children with healthy skin and 28 with diaper dermatitis were analysed. The severity of diaper dermatitis was assessed using a total symptoms score. RESULTS: Colonisation by candida sp. was significantly more frequent in children with diaper dermatitis as compared to those with healthy skin (perianal 75 vs. 19%; inguinal 50 vs. 10%; oral 68 vs. 25%, p < 0.0003), whereas colonisation by S. aureus at the 3 swab locations was not different (p > 0.34). There was a highly significant, positive correlation between severity of disease and extent of candida sp. colonisation at all swab locations. CONCLUSIONS: Limited microbial colonisation in diaper dermatitis is of questionable relevance, but extensive colonisation seems to aggravate the symptoms; therefore, we suggest that semi-quantitative evaluation should be preferred to the positive/negative assessment for a differential diagnosis.     

Microbiology of perianal cellulitis in children: comparison of skin swabs and needle aspiration

Objective To establish the aerobic and anaerobic microbiology of perianal cellulitis in children, comparing skin swab and needle aspirate methodology. Method Swabs of involved skin and needle aspirates of cellulitis were studied for aerobic and anaerobic bacteria. Results Specimens obtained from 10 patients with perianal cellulitis showed bacterial growth. Polymicrobial aerobic–anaerobic flora was found in all skin surface cultures, where the predominate isolates were Peptostreptococcus spp., Escherichia coli, and alpha hemolytic streptococci. The number of isolates in needle aspirates varied between one and two. The predominant ones were E.coli (3), Peptostreptococcus spp. (3), Staphylococcus aureus (2), and Bacteroides fragilis group (2). Complete or partial concordance in microbiology between skin swabs and needle aspirates was present in six instances. In four instances, isolates recovered from needle aspirates were not isolated from the skin surface. Conclusions This study demonstrates the diversity of aerobic and anaerobic organisms isolated from perianal cellulitis, and the superiority of needle aspirates in establishing the microbiology of the infection.     

Effects of Diaper Types on Diaper Dermatitis Associated with Diarrhea and Antibiotic Use in Children in Day-Care Centers

Infants and toddlers in day-care centers have a relatively high frequency of diarrhea and/or oral antibiotic use, and may be at increased risk of developing diaper dermatitis when diapered. A six-month, prospective, double-blind study was conducted in day-care centers in Houston, Texas, to determine the frequency of diarrhea, antibiotic use, and diaper dermatitis in infants and toddlers wearing conventional (cellulose-only core) disposable diapers or disposable diapers with a core of absorbent gelling material (AGM) and cellulose. A questionnaire was administered weekly to the day-care staff to gather health information, and weekly visual examinations were made of children for diaper dermatitis. The frequency of diarrhea was 1.9 episodes per child-year and that of antibiotic use was 3.3 courses per child-year. Infants diapered in disposable diapers with AGM had a significantly (P 0.032) lower mean grade of diaper dermatitis during diarrhea episodes and a lower (P 0.054) mean grade during antibiotic use, compared to those diapered in conventional disposable diapers. There was no significant difference between groups with regard to isolation of Staphylococcus aureus or Candida albicans from superficial skin cultures of the diapered area. The results indicate that diarrhea and antibiotic use occur frequently in children in day-care centers, and that the severity of diaper dermatitis is less in children wearing AGM disposable diapers than those wearing conventional disposable diapers in that setting.     

Perianal candidosis—a comparative study with mupirocin and nystatin

OBJECTIVE: To assess the efficacy and clinical outcome of 2% mupirocin in a polyethylene glycol base and nystatin cream as treatment regimens in diaper candidosis. DESIGN: A prospective randomized comparative study. METHODS: In vitro. The susceptibility of 20 clinical isolates of Candida albicans to 2% mupirocin, nystatin, and five additional antifungal agents was evaluated using the Nathan agar-well diffusion assay. The minimum inhibitory concentration (MIC) of mupirocin against the Candida species was determined using a tube dilution method. In vivo. Twenty patients (mean age, 12 months; range, 1 month to 4 years) with moderate to severe Monilia diaper dermatitis either had mupirocin ointment or nystatin cream applied to the infected area every 8 h or after every diaper change for a period of 7 days. Microscopic examination of skin scrapings and mycologic and microbiological cultures were performed before treatment and daily for 7 days, and progress was clinically assessed. RESULTS: In vitro. Topical mupirocin produced a greater zone of inhibition than nystatin cream, i.e. a mean of 27.2 mm (SD 1.55) compared with a mean of 17.3 mm (SD 1.08) for nystatin cream. MIC for mupirocin of 512 microg/mL in one case, 256 microg/mL in six cases, 200 microg/mL in 10 cases and 400 microg/mL in three cases were obtained for the 20 clinical isolates. C. albicans also displayed a universal sensitivity to mupirocin and nystatin. In vivo. Eradication of all Candida organisms was achieved within 2-6 days (mean, 2.6 days) in 10 patients receiving topical mupirocin therapy with rapid healing of the excoriated wounds (mean, 4.7 days). Both Gram-positive and Gram-negative bacteria were eradicated from the infected area within the trial period. Ten patients received topical nystatin cream and, in each case, Candida was successfully cleared within 5 days (mean, 2.8 days). Only three wounds were clinically healed within the trial period, however. The remaining seven wounds showed evidence of improved, but ongoing excoriated dermatitis and a heavy growth of polymicrobial organisms. CONCLUSIONS: Both agents eradicated Candida, the major difference being the marked response of the diaper dermatitis to mupirocin. Mupirocin should be applied topically 3-4 times daily or with each diaper change and is an excellent antifungal agent.     

The effects of amoxicillin therapy on skin flora in infants

In order to determine the effect of amoxicillin therapy on the perineal skin microbial flora in infants, we took quantitative bacterial and fungal cultures of perineal and sternal areas from 25 infants treated with amoxicillin (40 mg/kg/day) for 10 days. Specimens were obtained prior to therapy, within 3 days of conclusion of therapy, and 14-16 days later. Immediately following therapy, a decline in the number of bacterial isolates occurred on both the perineum (89 to 47) and sternum (84 to 39). The greatest decline occurred in the number of anaerobic bacteria (mostly Peptostreptococcus spp. and Propionibacterium acnes). Other organisms that were less often isolated were aerobic streptococci and Staphylococcus epidermidis. The number of Candida albicans isolates increased from 3 to 11 (p < 0.05) on the perineum, and 1 to 7 (p < 0.025) on the sternum. Four of the infants developed diaper dermatitis. The density of C. albicans increased more than 14-fold following amoxicillin therapy. Cultures done 14-16 days after cessation of therapy revealed an increase in the number of bacterial isolates on the perineum (47 to 72) and on the sternum (39 to 61) and a decline in recovery of C. albicans. This study demonstrates the effects of amoxicillin on the ecology of skin microbial flora in infants-a decrease in the number of bacterial isolates and an increase in recovery of C. albicans.     

Diagnosis and management of diaper dermatitis in infants with emphasis on skin microbiota in the diaper area

Diaper dermatitis is the most common inflammatory skin eruption within the diaper area in infants and toddlers. Although it rarely causes problems for prolonged periods of time, it causes considerable distress for both infants and parents. Diapered skin is exposed to friction, excessive hydration, varying pH, and is in constant contact with urine and feces, both of which are highly irritant to the skin. The three most common types of diaper dermatitis include chaffing dermatitis, irritant contact dermatitis, and diaper candidiasis. However, a variety of other skin conditions may manifest in the diaper area. Candida albicans and Staphylococcus aureus are most frequently isolated from the affected area and are thought to have a predominant role in diaper dermatitis. The review includes an overview of the epidemiology, etiology, and common skin microbiota in the diaper area. State‐of‐the‐art strategies for diagnosis, management, and prevention of diaper dermatitis are also included. Appropriate skin care can help in the prevention of diaper dermatitis and can aid the reparation of the skin. This review discusses common causes, skin microbiota within the diapered area, differential diagnosis, and finally possible prevention and treatment recommendations. Recent findings have proven that the key to efficient eradication of irritant diaper dermatitis lies in its prevention.     

Cutaneous microbiol flora in 206 children with diaper dermatitis and pyodermitis]

Staphylococcus aureus (60 p. 100) and Candida albicans (50 p. 100) were mostly found in 73 cases of diaper dermatitis. They were present together in 16 out of these 73 cases. This study enables us to think this is a matter of opportunistic infection. Staphylococcus aureus (75 p. 100) and beta-hémol. Streptococcus A (28 p. 100) were found in 40 children with impetigo contagiosa. They were present together in 7 out of the 40 cases. Nephritis was never found either in those cases or in other 93 cases of pyodermitis.