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The Generation R Study

Ankie Lebon, MSc; Joost A. M. Labout, MD; Henri A. Verbrugh, MD, PhD; Vincent W. V. Jaddoe, MD, PhD; Albert Hofman, MD, PhD; Willem J. B. van Wamel, PhD; Alex van Belkum, PhD; Henriëtte A. Moll, MD, PhD

Arch Pediatr Adolesc Med. 2009;163(8):745-749.

Objective  To study the association between Staphylococcus aureus nasal colonization and atopic dermatitis (AD) in infancy.

Design  Population-based prospective cohort study of pregnant women and their children.

Setting  This project was embedded in the Generation R Study.

Participants  A total of 1079 postnatal Dutch infants/children participated in the focus cohort.

Main Exposures  Nasal swabs for S aureus cultivation were taken at ages 1.5, 6, and 14 months.

Main Outcome Measure  Questionnaires that pertain to AD and confounders (birth weight, gestational age, sex, and parental eczema) were completed prenatally and postnatally. The outcome was AD in the first and second years of life.

Results  A first positive culture for S aureus at age 6 months was associated with AD prevalence in the first and second years of life (adjusted odds ratio [aOR], 2.13; 95% confidence interval [CI], 1.17-3.87; and aOR, 2.88; 95% CI, 1.60-5.19, respectively) and also with severity (aOR, 3.27; 95% CI, 1.30-8.03). Moreover, frequent colonization in the first year of life (2 times) held a 4.29-fold (95% CI, 1.03- to 17.88-fold) risk of moderate to severe AD in the second year of life.

Conclusion  Colonization with S aureus at age 6 months and frequent colonization in the first year of life are associated with AD and its severity in young children.

Author Affiliations: Generation R Study Group (Drs Labout, Jaddoe, Hofman, and Moll and Ms Lebon) and Departments of Medical Microbiology and Infectious Diseases (Drs Verbrugh, van Wamel, and van Belkum and Ms Lebon) and Epidemiology (Drs Jaddoe and Hofman), Erasmus Medical Center, and Department of Pediatrics, Erasmus Medical Center–Sophia Children's Hospital (Drs Labout, Jaddoe, and Moll and Ms Lebon), Rotterdam, the Netherlands.

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