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Amber necklaces: reasons for use and awareness of risk associated with bacterial colonisation

  • Clinical report
  • Published:
European Journal of Dermatology Aims and scope

Abstract

Background

Parents are increasingly placing amber necklaces on their infants or toddlers to prevent teething pain. The use of the necklaces can pose a risk of death by strangulation, however, there are no data on the potential infectious risk linked to bacterial colonisation associated with the necklaces.

Objectives

We aimed to analyse bacterial colonisation of amber necklaces worn by children during hospital consultations.

Material & methods

This prospective observational study included all children wearing a teething necklace at consultation in the Paediatric Dermatology and the Paediatric Emergency Department of our hospital from April to December 2014. The study included 27 children (median age: 10.7 months; 70.4% female). The surface of necklaces underwent bacteriological analyses using three different agar cultures. Parents completed a brief questionnaire to provide reasons for using necklaces and express awareness of risks.

Results

One child had a history of impetigo. All necklaces were colonised by bacteria (median: four species per necklace [range: 1-9]); 32 different species were found, the most frequent being coagulase-negative staphylococci (Staphylococcus epidermidis in 88.9% of cases). In three cases, methicillin-sensitive Staphylococcus aureus was found. The most frequent reason for wearing a necklace was to prevent teething pain (n = 17; 63.0%); the necklace was judged effective (moderately/highly effective) in 74.1% of cases, however, 70.4% of parents considered the use of the necklace to be risky.

Conclusion

Amber necklaces may be highly colonised by commensal germs of the skin, mainly coagulase-negative staphylococci. Although these bacteria are saprophytes, they may become pathogenic in particular conditions.

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Authors and Affiliations

  1. University François Rabelais Tours, 37044, Tours Cedex 9, France

    Pauline Machet, Philippe Lanotte, Bruno Giraudeau & Annabel Maruani

  2. Department of Dermatology, Unit of Paediatric Dermatology, CHRU Tours, 37044, Tours Cedex 9, France

    Pauline Machet & Annabel Maruani

  3. Department of Bacteriology-Virology-Hygiene, Unit of Bacteriology, CHRU Tours, 37044, Tours Cedex 9, France

    Philippe Lanotte & Marie Leperlier

  4. Clinical Investigation Center - INSERM 1415, CHRU Tours, 37044, Tours Cedex 9, France

    Bruno Giraudeau & Elsa Tavernier

Authors
  1. Pauline Machet
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  2. Philippe Lanotte
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  3. Bruno Giraudeau
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  4. Marie Leperlier
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  5. Elsa Tavernier
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  6. Annabel Maruani
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Corresponding author

Correspondence to Annabel Maruani.

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Machet, P., Lanotte, P., Giraudeau, B. et al. Amber necklaces: reasons for use and awareness of risk associated with bacterial colonisation. Eur J Dermatol 26, 580–585 (2016). https://doi.org/10.1684/ejd.2016.2871

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  • DOI: https://doi.org/10.1684/ejd.2016.2871

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