Adherence by Staphylococcus intermedius to canine

corneocytes: a preliminary study comparing

noninflamed and inflamed atopic canine skin
Blackwell Publishing Ltd

Neil A. McEwan*, Dominic Mellor

and Gabriel Kalna
*University of Liverpool, Small Animal Hospital, Crown Street,
Liverpool, L7 7EX, UK
Division of Animal Production and Health, Institute of Comparative
Medicine, University of Glasgow Veterinary School, Bearsden,
Glasgow G61 1QH, UK
University of Strathclyde, 16 Richmond Street, Glasgow,
G1 1XQ, UK
Correspondence: Neil A. McEwan, University of Liverpool, Small
Animal Hospital, Crown Street, Liverpool, L7 7EX, UK.
Tel.: 0151 794 4290;
Fax: 0151 794 4305;
E-mail: n.a.mcewan@liverpool.ac.uk

Abstract
The adherence by three strains of Staphylococcus
intermedius to corneocytes collected from healthy
dogs was compared to the adherence to corneocytes
collected from the inflamed (erythematous) and noninflamed (normal appearing) skin of dogs suffering
from atopic dermatitis. All three strains of S. intermedius adhered in greater numbers to corneocytes from
both inflamed and noninflamed atopic skin than to
corneocytes from healthy dogs. Adherence was greatest to corneocytes from inflamed atopic skin but one
strain showed no statistical difference for adherence
to inflamed and noninflamed atopic skin. These findings suggest that S. intermedius adheres extensively
to both inflamed and noninflamed canine atopic skin.
This may be important in the colonization of atopic
skin by this microorganism. Strain variation in the
ability of S. intermedius to adhere to canine atopic
corneocytes is probable.
Received 30 September 2005; accepted 14 December
2005

Introduction
Studies have demonstrated that Staphylococcus aureus
adheres avidly to the corneocytes of humans with atopic
dermatitis.1 Adherence is therefore considered an important factor in the colonization and subsequent invasion of
human atopic skin. Several adhesins for S. aureus have
been identified. The most commonly studied are that for
fibrinogen, fibronectin and collagen.2,3 In contrast, little is
known about adhesion to canine atopic skin by Staphylococcus intermedius, which has been shown to adhere to

canine corneocytes. More bacteria adhere to corneocytes

from atopic dogs than from healthy dogs.47 Adherence
may be greater in atopic dogs that display a high level of
pruritus.8 Recent studies have shown a T-helper type 2
inflammatory environment promotes binding of S. aureus
to the skin. This is mediated by fibrinogen and fibronectin and
may explain the high level of colonization of human atopic
skin by S. aureus.9 In this study the adherence by S. intermedius to canine corneocytes collected from healthy skin,
noninflamed and inflamed atopic skin was compared.

Materials and methods

Populations studied
Healthy dogs
This group of 10 dogs had no history of skin disease and were free
from skin and other disease on clinical examination. The group
included eight different breeds with a mean age of 4.8 years (SD
2.70 years). There were five entire females, two neutered females
and three entire males.
Dogs with atopic dermatitis
A diagnosis of atopic dermatitis was established by compatible history, clinical findings and ruling out other potential causes of their skin
disease. All 10 dogs had at least one positive intradermal test reaction
for common environmental allergens. The group included nine different breeds with a mean age of 4.4 years (SD 2.07 years). There were
five entire females, two neutered females and three entire males.
No dog in the study had received systemic or topical treatment for
at least 3 weeks prior to sampling.

Corneocyte collection
A scrub cup technique10 was used to collect corneocytes from a 6cm2 area of skin. The scrub cup was placed over the skin area to be
sampled and held tightly in place. Two millilitres of sterile phosphate
buffered saline (PBS 0.01 mol L1) were placed in the cup and, using
a plastic spatula, the skin surface was gently agitated for 30 s. The
corneocyte cell suspension was then collected into a centrifuge tube
by pipette. Samples were collected from the skin of healthy dogs, noninflamed (nonerythematous) atopic skin and inflamed (lesional, erythematous) atopic skin. Erythematous skin that was not affected by
self-trauma was chosen for sampling the latter. The sparsely haired
areas of the inner thigh and groin were selected as sampling sites for
all dogs.
After collection, corneocytes were mixed vigorously for 60 s using
a vortex mixer (Autovortex Mixer SA2, Stuart Scientific, UK) to break
up any sheets of corneocytes. The corneocytes were then washed by
centrifugation in three changes of PBS. The resulting suspension of
corneocytes was adjusted to approximately 1 104 corneocytes per
millilitre of PBS by counting in a haemocytometer.

Staphylococcal isolates
Three strains of S. intermedius were obtained from clinical cases. Two
different isolates designated A and B were obtained from superficial
pyoderma lesions in two different dogs. Another strain, designated C,

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Adherence assay
The adherence assay and counting methods have been published.6
Briefly, 1 mL of corneocyte suspension was incubated with 1 mL of
staphylococcal suspension. A control consisting of 1 mL of corneocytes with 1 mL of sterile PBS was used. The suspensions were
placed in a shaking water bath (Grant Instruments (Cambridge) Ltd,
Cambridge, United Kingdom) and incubated at a temperature of 38 C
for 45 min, after which the corneocytes were collected on polycarbamate filters (Nucleopore Corporation Filtration Products, Nucleopore Canada, Inc., Toronto) with a pore size of 25 m and washed
with 300 mL of sterile PBS.
The filters were then placed on clean glass microscope slides air
dried and stained with a thiazine dye in phosphate buffer (Diff-Quik
Stain solution II, Baxter Dale AG, Switzerland). The stained filter was
finally mounted in DPX under a number 1 glass cover slip.
Each filter was examined under oil immersion ( 1000 magnification) and the number of cocci on each of 100 consecutive corneocytes
recorded. The source of individual slides was unknown to the observer.

Statistical analysis
One-way analysis of variance (ANOVA) was used to compare
groups and when the data were not normally distributed or if variance
was unequal, the KruskalWallis ANOVA on ranks was employed.
Pairwise multiple comparisons were made using the Tukey test or
Dunns method. A level of P < 0.05 was used to indicate a statistically
significant difference.

Results
Healthy dogs
A total of 33 samples were collected from 10 dogs. The
mean standard deviation for the three strains of Staphylococcus and the control were; A, 3.64 11.98; B,
4.11 13.03; C, 4.16 13.16; control, 0.25 2.28 (Fig. 1).
There were no significant differences between the three
strains of S. intermedius (A, B and C) in adherence to
healthy corneocytes. All test groups (A, B and C) had
significantly higher numbers of adherent cocci compared
with the control group.

Figure 1. Box and whisker plots representing the results of adherence

by Staphylococcus intermedius strains A, B and C to corneocytes
collected from healthy dogs, noninflamed and inflamed atopic skin.
The line in the middle of the box represents the median value and the
box extends from the 25th to the 75th percentile. The error bars
extend from the lowest to the highest values.

was isolated from purulent material collected from a canine deep pyoderma case of muzzle furunculosis.
All staphylococci were identified by the API method, cultured on
sheep blood agar, subcultured into liquid medium (Oxoid Nutrient Broth.
No. 2. Unipath Ltd, Basingstoke, Hampshire, England) and frozen at
70 C in 1 mL aliquots.
When required, a frozen aliquot of staphylococci was thawed and
plated on sheep blood agar and incubated at 38 C for 24 h. Colonies
were harvested and placed in a centrifuge tube with 10 mL of sterile
PBS. The cocci were washed in three changes of PBS by centrifugation
and the resulting suspension adjusted to an optical density of 0.5 at
570 nm. Such a suspension had previously been determined to
correspond to approximately 1 10 6 colony-forming units per
millilitre.11

152

Atopic dogs; sampling from noninflamed skin

Twenty-three samples were collected from nine dogs. The
mean standard deviation for the three strains of
Staphylococcus and the control were; A, 6.08 14.61; B,
5.98 15.78; C, 7.74 18.21; control, 0.34 3.25 (Fig. 1).
Significantly more cocci of Staphylococcus strain C
adhered compared with strain B (P < 0.001). No significant
difference was detected between strains A and B. All test
groups (A, B and C) had significantly higher numbers of
adherent cocci compared with the control group.
Atopic dogs; sampling from inflamed skin
Nineteen samples were collected from eight dogs. The
mean standard deviation for the three strains of
Staphylococcus and the control were; A, 5.43 14.50;
B, 7.34 15.50; C, 10.20 19.62; control, 0.32 3.02
(Fig. 1). All test groups (A, B and C) had significantly higher
numbers of adherent cocci compared with the control
group. Staphylococcus strain C adhered in larger numbers
compared with A or B (P < 0.001).
Staphylococcal adhesion to atopic and healthy
corneocytes
Strains A, B and C all adhered to a significantly greater
extent to both inflamed and noninflamed canine atopic

2006 The Authors. Journal compilation 2006 European Society of Veterinary Dermatology.

Staphylococcus intermedius adherence to canine corneocytes

Figure 2. The mean values for each of the three bacterial strains
(a, b and c) are shown for each of the three different skin samples
(healthy skin, noninflamed and inflamed atopic skin). The bar
represents the mean value for all three bacteria strains.

skin compared to healthy canine skin (P < 0.05) (Fig. 2).

Strains B and C adhered to a significantly greater extent to
inflamed skin compared with noninflamed skin (P < 0.001),
whereas strain A showed no difference between inflamed
and noninflamed skin.

Discussion
Two previous studies5,6 have shown that S. intermedius
adheres preferentially to canine atopic corneocytes than
to healthy canine corneocytes. In this study, all three
strains tested adhered significantly more to both inflamed
and noninflamed canine atopic corneocytes than to healthy
canine corneocytes. This is consistent with previous
studies. Two strains (B and C) adhered in larger numbers
to inflamed atopic skin, but no difference in adherence
for strain A was seen between cells from inflamed and
noninflamed skin. This may indicate strain variation in the
ability of S. intermedius to adhere to canine atopic corneocytes. This could be associated with the presence or
absence of specific microbial adhesins. Strain variation in
the ability of staphylococci to adhere to cells has been
recognized.6,7,12
Staphylococcus aureus is known to express a number
of cell surface proteins that bind fibrinogen, fibronectin
and collagen.2,13 Fibronectin deposition has been demonstrated in the upper epidermis and stratum corneum of
noninflamed human atopic skin but not in similar sites
from healthy human skin.14 Strains of S. aureus genetically
engineered so they lacked fibronectin-binding proteins
showed a significant reduction in binding to human atopic
but not healthy skin.14 From this it was concluded that
fibronectin is a key molecule in the binding of S. aureus
to human atopic skin. In addition, in humans and dogs,
there is considerable evidence that the acute inflammatory response of atopic dermatitis is mediated via a T
helper type 2 reaction.1518 In a mouse model, S. aureus
was shown to bind preferentially to skin sites undergoing
a T-helper type 2 mediated inflammatory reaction and that
this binding was mediated by fibrinogen and fibronectin.19
Although both fibronectin and fibrinogen are plasma
proteins that leak into tissue during inflammation, this is

unlikely to be the sole mechanism whereby S. aureus

adheres to human atopic skin. IL-4 is known to play a key
role in the pathogenesis of canine and human atopic dermatitis.16,17,20 In humans, IL-4 is highly expressed in both
unaffected and inflamed atopic skin15 and significant
increases in fibronectin have been demonstrated in IL-4treated mouse skin.2 A possible source of this fibronectin
is through IL-4-induced fibronectin synthesis by fibroblasts.21,22 It is probable that at least some strains of S. intermedius bind to fibrinogen and fibronectin.23 Strain
variation in the ability to bind fibronectin may explain the
differences of the three staphylococcal strains studied
here. Given the many similarities in the immunopathogenesis of canine and human atopic dermatitis, it is not unreasonable to speculate that the mechanisms responsible
for the increased adherence shown by S. intermedius
to canine atopic skin are comparable to that shown by
S. aureus to human atopic skin.

Conclusions
This study showed enhanced binding by three strains of
S. intermedius to corneocytes from both noninflamed and
inflamed canine atopic skin compared with healthy canine
skin. It is hypothesized that a T-helper type 2 inflammatory
environment in canine atopic skin allows enhanced binding by S. intermedius, leading to colonization of skin and
predisposing to the staphylococcal pyoderma seen in
canine atopic dermatitis. Further studies are required to
determine the role of S. intermedius binding to fibronectin
and fibrinogen in healthy and atopic canine skin.

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Rsum Ladhrence de trois souches de S. intermedius des cornocytes obtenues partir de chiens
sains a t compare ladhrence des cornocytes obtenus dune zone inflamme (rythmateuse)
et non inflamme (dapparence normale) de chiens atopiques. Les trois souches de S. intermedius adhraient
en plus grand nombre aux cornocytes des chiens atopiques ( la fois en zone inflamme et en zone non
inflamme) quaux cornocytes des chiens sains. Ladhrence la plus importante tait note en peau
inflamme, mais pour une souche aucune diffrence significative na t observe entre peau inflamme
et peau non inflamme. Ces rsultats suggrent que S. intermedius adhre de faon importante la peau
inflamme ou non inflamme des chiens atopiques. Ceci pourrait tre important dans le phnomne de
colonisation de la peau atopique par les microorganismes. Des variations de souches pour les capacits
dadhsion sont halement probables.
Resumen Se compar la adherencia de tres cepas de S. Intermedius a corneocitos recogidos de perros
sanos con la adherencia a corneocitos obtenidos de perros con dermatitis atpica en zonas inflamadas
(eritematosas) y no inflamadas (apariencia normal). Las tres cepas demostraron mayor numero de bacterias
adheridas a corneocitos de piel atpica inflamada y no inflamada, que a corneocitos de perros sanos. La
adherencia tambin fue mayor a corneocitos de la piel atpica inflamada, aunque una cepa no demostr
diferencia significativa con la piel atpica no inflamada. Estos hallazgos sugieren que S. intermedius se adhiere
de forma extensiva a la piel inflamada y no inflamada de perros atpicos. Esta caracterstica puede tener
relevancia en la colonizacin de la piel en perros atpicos por este microorganismo. Es probable que existan
diferencias entre cepas de S. Intermedius en la capacidad adherencia a corneocitos de perros atpicos.
Zusammenfassung Das Anhaften von drei Stmmen von S. intermedius an Korneozyten, die von gesunden
Hunden gesammelt worden waren, wurde verglichen mit dem Anhaften an Korneozyten, die von entzndeter (erythematser) und nicht-entzndeter (normal erscheinender) Haut von Hunden entnommen wurden,
die an atopischer Dermatitis leiden. Alle drei Stmme von S. intermedius hafteten in grerer Anzahl an
den Korneozyten von sowohl entzndeter als auch nicht-entzndeter atopischer Haut, als an Korneozyten
von gesunden Hunden. Das Anhaften war am strksten an Korneozyten von entzndeter atopischer Haut,
allerdings zeigte ein Stamm keinen signifikanten Unterschied zwischen dem Anhaften an entzndeter und
nicht-entzndeter atopischer Haut. Diese Ergebnisse weisen darauf hin, dass S. intermedius weitgehend
an sowohl entzndeter als auch nicht-entzndeter caniner atopischer Haut haftet. Mglicherweise ist das
wichtig bei der Kolonisation von atopischer Haut durch diesen Mikroorganismus. Eine Variation der Stmme
bei der Fhigkeit von S. intermedius an caninen atopischen Korneozyten anzuhaften ist wahrscheinlich.

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