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Abstract

The human skin is a complex habitat. It comprises areas that are relatively dry, such as the forearm, and others that are moist, such as the perineum and toewebs. Some areas have abundant lipid from sebaceous glands, such as the face, scalp and upper chest and back, while some, such as the axillae, also have secretions from specialized apocrine glands. Areas with many eccrine sweat glands may become highly saline as watery sweat induced by heat or exercise evaporates. On balance, an average adult has a total skin surface area of about 1.5 m2 with a pH of about 5.5 and a temperature between 30° and 37 °C with substantial local variations. The various skin secretions supply amino acids, metal ions, fatty acids, sugars and other nutrient materials although in dilute solution (Marples, 1965; Noble, 1981, 1993). It should therefore be no surprise that skin is inhabited by many different microorganisms, some of which may be fairly localized.

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References

  • Abe, T., Mayuzumi, J., Kikuchi, N. and Arai, S. (1980) Seasonal variations in skin temperature, skin pH, evaporative water loss and skin surface lipid values on human skin. Chemical Pharmaceutical Bulletin, 8, 387–392.

    Article  Google Scholar 

  • Aly, R., Shirley, C., Cunico, B. and Maibach, H. I. (1978) Effect of prolonged occlusion on the microbial flora, pH, carbon dioxide and transepidermal water loss on human skin. Journal of Investigative Dermatology, 71, 378–381.

    Article  PubMed  CAS  Google Scholar 

  • Armstrong, R. W. and Wuerflein, R. D. (1996) Endocarditis due to Propionibacterium granulosum. Clinical Infectious Diseases, 23, 1178–1179.

    Article  CAS  Google Scholar 

  • Bandahaya, M. (1993) The distribution of Malassezia furfur and Malassezia pachydermatis on normal human skin. Southeast Asian Journal of Tropical Medicine and Public Health, 24, 343–346.

    Google Scholar 

  • Barton, L. L. and Friedman, A. D. (1987) Impetigo: a reassessment of etiology and therapy. Pediatric Dermatology, 4, 185–188.

    Article  PubMed  CAS  Google Scholar 

  • Batson, J. H., Mukkamala, R., Byrd, R. P. Jr and Roy, T. M. (1996) Pulmonary abscess due to Corynebacterium striatum. Journal of the Tennessee Medical Association, 89, 115–116.

    CAS  Google Scholar 

  • Belsey, M. A. and LeBlanc, D. R. (1975) Skin infections and the epidemiology of diphtheria: acquisition and persistence of C. diphtheriae infection. American Journal of Epidemiology, 102, 179–184.

    PubMed  CAS  Google Scholar 

  • Berger, S. A., Gorea, A., Stadler J. et al. (1984) Recurrent breast abscesses caused by Corynebacterium minutissimum. Journal of Clinical Microbiology, 20, 1219–1220.

    CAS  Google Scholar 

  • Berner, R., Pelz, K., Wilhelm, C. et al. (1997) Fatal sepsis caused by Corynebacterium amycolatum in a premature infant. Journal of Clinical Microbiology, 35, 1011–1012.

    PubMed  CAS  Google Scholar 

  • Bibel, D. J., Bayles, C., Strauss, W. G. et al. (1983) Competitive adherence as a mechanism of bacterial interference. Canadian Journal of Microbiology, 29, 700–703.

    Article  PubMed  CAS  Google Scholar 

  • Bradley, S. F. (1997) Methicillin-resistant Staphylococcus aureus in nursing homes. Epidemiology, prevention and management. Drugs and Aging, 10, 185–198.

    Article  PubMed  CAS  Google Scholar 

  • Brazier, J. S. and Hall, V. (1993) Propionibacterium propionicum and infections of the lachrymal apparatus. Clinical Infectious Diseases 17 892–893.

    Google Scholar 

  • Brook, I. (1994) Infection caused by propionibacterium in children. Clinical Pediatrics, 33, 485–490.

    Article  PubMed  CAS  Google Scholar 

  • Carr, D. L. and Kloos, W. E. (1977) Temporal study of the staphylococci and micrococci of normal infant skin. Applied and Environmental Microbiology, 34, 673–680.

    PubMed  CAS  Google Scholar 

  • Coyle, M. B., Leonard, R. B., Nowowiejski, D. J. et al. (1993) Evidence of multiple taxa within commercially available reference strains of Corynebacterium xerosis. Journal of Clinical Microbiology, 31, 1788–1793.

    CAS  Google Scholar 

  • Critchley, G. and Strachan, R. (1996) Postoperative subdural empyema caused by Propionibacterium acnes — a report of two cases. British Journal of Neurosurgery, 10, 321–323.

    Article  PubMed  CAS  Google Scholar 

  • Cuny, C. and Witte, W. (1996) Typing of Staphylococcus aureus by PCR for DNA sequences flanked by transposon Tn916 target region and ribosomal binding site. Journal of Clinical Microbiology, 34, 1502–1505.

    PubMed  CAS  Google Scholar 

  • Dancer, S. J. and Noble, W. C. (1991) Nasal, axillary and perineal carriage of Staphylococcus aureus among women: identification of strains producing epidermolytic toxin. Journal of Clinical Pathology, 44, 681–684.

    Article  PubMed  CAS  Google Scholar 

  • Dancer, S. J., Simmons, N. A., Poston, S. M. and Noble, W. C. (1988) Outbreak of staphylococcal scalded skin syndrome among neonates. Journal of Infection, 16, 87–103.

    Google Scholar 

  • Davies, S. J., Ogg, C. S., Cameron, J. S. et al. (1989) Staphylococcus aureus nasal carriage, exit-site infection and catheter loss in patients treated with continuous ambulatory peritoneal dialysis (CAPD). Peritoneal Dialysis Bulletin, 9, 61–64.

    Google Scholar 

  • Esteban, J., Ramos, R. M., Jiminez-Castillo, P. and Soriano, F. (1995) Surgical wound infections due to Propionibacterium acnes: a study of 10 cases. Journal of Hospital Infection, 30, 229–232.

    Article  PubMed  CAS  Google Scholar 

  • Estoppey, O., Rivier, G., Blane, C. H. et al. (1997) Propionibacterium avidum sacroiliitis and osteomyelitis. Revue du Rhumatisme (English edn), 64, 54–56.

    Google Scholar 

  • Etienne, J. and Eykyn, S. J. (1990) Increase in native valve endocarditis caused by coagulase-negative staphylococci: an Anglo-French clinical and microbiological study. British Heart Journal, 64, 381–384.

    Google Scholar 

  • Fan, S. T., Teoh-Chan, C. H., Lau, K. F. et al. (1988) Predictive value of surveillance skin and hub cultures in central venous catheter sepsis. Journal of Hospital Infection, 12, 191–198.

    Article  PubMed  CAS  Google Scholar 

  • Funke, G., Stubbs, S., Pfyffer, G. E. et al. (1994) Characteristics of CDC group 3 and group 5 coryneform bacteria isolated from clinical specimens and assignment to the genus Dermabacter. Journal of Clinical Microbiology, 32, 1223–1228.

    CAS  Google Scholar 

  • Funke, G., von Graevenitz, A., Clarridge, J. E. III and Bernard, K. A. (1997) Clinical microbiology of coryneform bacteria. Clinical Microbiology Reviews, 10, 125–159.

    Google Scholar 

  • Goodacre, R. Howell, S. A., Noble W. C. and Neal, M. J. (1996) Sub-species discrimination, using pyrolysis mass spectrometry and self-organinising neural networks, of Propionibacterium acnes isolated from normal human skin. Zentralblatt far Bakteriologie. International Journal of Medical Microbiology, Virology, Parasitology and Infectious Diseases,284 501–515.

    Google Scholar 

  • Gower, D. B., Nixon, A. and Mallet, A. I. (1988) The significance of odorous steroids in axillary odour, in Perfumery: The Psychology and Biology of Fragrance, (eds S. van Toller and G. H. Dodd ), Chapman liuya Hall, London, pp. 47–85.

    Google Scholar 

  • Grimont, P. A. D. and Bouvet, P. J. M. (1991) Taxonomy of acinetobacter, in The Biology of Acinetobacter, (eds K. J. Towner, E. Bergogne-Berezin and C. A. Few-son ), Plenum Press, New York, pp. 25–36.

    Google Scholar 

  • Gruner, E., Steigerwalt, A. G., Hollis, D. G. et al. (1994) Recognition of Dermabacter hominis, formerly CDC fermentative coryneform group 3 and group 5, as a potential human pathogen. Journal of Clinical Microbiology, 32, 1918–1922.

    PubMed  CAS  Google Scholar 

  • Gueho, E., Midgley, G. and Guillot, J. (1996) The genus Malassezia with description of four new species. Antonie van Leeuwenhoek, 69, 337–355.

    Article  PubMed  CAS  Google Scholar 

  • Howell, S. A., Clayton, Y. M., Phan Q. G. and Noble, W. C. (1988) Tinea pedis: the relationship between symptoms, organisms and host characteristics. Microbial Ecology in Health and Disease, 1, 131–133.

    Article  Google Scholar 

  • Ingham, E., Holland, K. T., Gowland, G. and Cunliffe, W. J. (1983) Studies of the intracellular proteolytic activity produced by Propionibacterium acnes. Journal of Applied Bacteriology, 54, 263–271.

    Article  Google Scholar 

  • Iwantscheff, A., Kuhnen, E. and Brandis, H. (1985) Species distribution of coagulase-negative staphylococci isolated from clinical sources. Zentralblatt far Bakteriologie, Mikrobiologie, and Hygiene, Serie A, 260, 41–50.

    CAS  Google Scholar 

  • Jones, D. and Collins, M. D. (1988) Taxonomic studies on some human cutaneous coryneform bacteria: description of Dermabacter hominis gen. nov., sp. nov. FEMS Microbiology Letters, 51, 51–56.

    Article  Google Scholar 

  • Kaukoranta-Tolvanen, S. S., Sivonen, A., Kostiala, A. A. et al. (1995) Bacteremia caused by Brevibacterium species in an immunocompromised patient. European Journal of Clinical Microbiology and Infectious Diseases, 14, 801–804.

    Article  CAS  Google Scholar 

  • Kay, C. R. (1962) Sepsis in the home. British Medical Journal, i, 1048–1052.

    Google Scholar 

  • Khatib, R., Riederer, K. M., Clark, J. A. et al. (1995) Coagulase-negative staphylococci in multiple blood cultures: strain relatedness and determinants of samestrain bacteremia. Journal of Clinical Microbiology, 33, 816–820.

    PubMed  CAS  Google Scholar 

  • Knols, B. G. J. (1996) On human odour, malaria mosquitoes, and Limburger cheese. Lancet, 348, 1322.

    Article  PubMed  CAS  Google Scholar 

  • Leeming, J. P., Holland, K. T. and Cunliffe, W. J. (1988) The microbial colonization of inflamed acne vulgaris lesions. British Journal of Dermatology, 118, 203–208.

    Google Scholar 

  • Leonard, R. B., Nowowiejski, D. J., Warren, J. J. et al. (1994) Molecular evidence of person-to-person transmission of a pigmented strain of Corynebacterium striatum in intensive care units. Journal of Clinical Microbiology, 32, 164–169.

    Google Scholar 

  • Ludlam, H. A., Noble, W. C., Marples, R. R. et al. (1989) The epidemiology of peritonitis caused by coagulase-negative staphylococci in continuous ambulatory peritoneal dialysis. Journal of Medical Microbiology, 30, 167–174.

    Article  PubMed  CAS  Google Scholar 

  • McBride, M. E., Ellner, K. M., Black, H. S. et al. (1993) A new Brevibacterium sp. isolated from infected genital hair of patients with white piedra. Journal of Medical Microbiology, 39, 255–261.

    Article  PubMed  CAS  Google Scholar 

  • Magee, J. T., Burnett I. A., Hindmarsh, J. M. and Spencer, R. C. (1990) Micrococcus and Stomatococcus spp. from human infections. Journal of Hospital Infection, 16, 67–73.

    CAS  Google Scholar 

  • Marcon, M. J. and Powell, D. A. (1992) Human infections due to Malassezia spp. Clinical Microbiology Reviews, 5, 101–119.

    CAS  Google Scholar 

  • Marples, M. J. (1965) The Ecology of Human Skin, Charles C. Thomas, Springfield, IL.

    Google Scholar 

  • Massey, A., Mowbray, J. F. and Noble, W. C. (1978) Complement activation by Corynebacterium acnes. British Journal of Dermatology, 98, 583–584.

    Article  CAS  Google Scholar 

  • Matta, M. (1974) Carriage of Corynebacterium acnes in school children in relation to age and race. British Journal of Dermatology, 91, 557–561.

    Article  PubMed  CAS  Google Scholar 

  • Moreno, F., Crisp, C., Jorgensen, J. H. and Patterson, J. E. (1995) Methicillinresistant Staphylococcus aureus as a community organism. Clinical Infectious Diseases, 21, 1308–1312.

    Article  PubMed  CAS  Google Scholar 

  • Mukai, H., Kaneko, S., Saito, N. et al. (1997) Clinical significance of Malassezia furfur specific IgE antibody in atopic dermatitis. Arerugi — Japanese Journal of Allergology, 46, 26–33.

    CAS  Google Scholar 

  • Naidoo, J. (1984) Interspecific co-transfer of antibiotic resistance plasmids in staphylococci in vivo. Journal of Hygiene, Cambridge, 93, 59–66.

    CAS  Google Scholar 

  • Naidoo, J. and Noble, W. C. (1978) Transfer of gentamicin resistance between strains of Staphylococcus aureus on skin. Journal of General Microbiology, 107, 391–395.

    Article  PubMed  CAS  Google Scholar 

  • Noble, W. C. (1981) Microbiology of Human Skin, Lloyd-Luke, London.

    Google Scholar 

  • Noble, W. C. (ed.) (1993) The Skin Microflora and Microbial Skin Disease, Cambridge University Press, Cambridge.

    Google Scholar 

  • Noble, W. C., Valkenburg, H. A. and Wolters, C. H. L. (1967) Carriage of Staphylococcus aureus in random samples of the normal population. Journal of Hygiene, Cambridge, 65, 567–573.

    CAS  Google Scholar 

  • Noble, W. C., Virani, Z. and Cree, R. G. A. (1992) Co-transfer of vancomycin and other resistance genes from Enterococcus faecalis NCTC12201 to Staphylococcus aureus. FEMS Microbiology Letters, 93, 195–198.

    Article  CAS  Google Scholar 

  • Noble, W. C., Rahman, M., Karadec, T. and Schwarz, S. (1996) Gentamicin resistance gene transfer from Enterococcus faecalis and E. faecium to Staphylococcus aureus, S. intermedius and S. hyicus. Veterinary Microbiology, 52, 143–152.

    Article  CAS  Google Scholar 

  • Nordstrom, K. M., McGinley, K. J. Cappriello, L. et al. (1987) Pitted keratolysis: the role of Micrococcus sedentarius. Archives of Dermatology,123 1320–1325.

    Google Scholar 

  • Papapetropoulos, M., Pappas, A., Papavassiliou, J. and Legakis, N. J. (1981) Distribution of coagulase-negative staphylococci in human infections. Journal of Hospital Infection, 2, 145–153.

    Google Scholar 

  • Pascual, C., Collins, M. D., Funke, G. and Pitcher, D. G. (1996) Phenotypic and genotypic characterisation of two brevibacterium strains from the human ear: description of Brevibacterium otitidis sp. nov. Medical Microbiology Letters, 5, 113–123.

    CAS  Google Scholar 

  • Pennie, R. A., Malik, A. S. and Wilcox, L. (1996) Misidentification of toxigenic Corynebacterium diphtheriae as a Corynebacterium species with low virulence in a child with endocarditis. Journal of Clinical Microbiology, 34, 1275–1276.

    PubMed  CAS  Google Scholar 

  • Petts, D. N., Noble, W. C. and Howell, S. A. (1997) Potential for gene transfer among enterococci from a single patient and the possibility of confounding typing results. Journal of Clinical Microbiology, 35, 1722–1727.

    PubMed  CAS  Google Scholar 

  • Pitcher, D. G. and Malnick, H. (1984) Identification of Brevibacterium from clinical sources. Journal of Clinical Pathology, 37, 1395–1398.

    Article  PubMed  CAS  Google Scholar 

  • Polakoff, S., Richards, I. D. G., Parker M. T. and Lidwell, O. M. (1967) Nasal and skin carriage of Staphylococcus aureus by patients undergoing surgical operation. Journal of Hygiene, Cambridge, 65, 559–566.

    CAS  Google Scholar 

  • Refsahl, K. and Andersen, B. M. (1992) Clinically significant coagulase-negative staphylococci: identification and resistance patterns. Journal of Hospital Infection, 22, 19–31.

    Article  PubMed  CAS  Google Scholar 

  • Reuther, J. W. A. and Noble, W. C. (1993) An ecological niche for Staphylococcus saprophyticus. Microbial Ecology in Health and Disease, 6, 209–212.

    Article  Google Scholar 

  • Saavedra, J. Rodriguez, J. N., Fernandez-Jurado, A. et al. (1996) A necrotic soft-tissue lesion due to Corynebacterium urealyticum in a neutropenic child. Clinical Infectious Diseases,22 851–852.

    Google Scholar 

  • Saint-Leger, D. Bague, A., Cohen, E. and Chivot, M. (1986) A possible role for squalene in the pathogenesis of acne I. In vitro study of squalene oxidation. British Journal of Dermatology,114 535–542.

    Google Scholar 

  • Saionji, K. and Shitara, M. (1992) Carrier state and comparative study of methicillin-resistant Staphylococcus aureus from the staff and patients. Japanese Journal of Clinical Medicine, 50, 998–1003.

    PubMed  CAS  Google Scholar 

  • Schlievert, P. M. (1993) Role of superantigens in human disease. Journal of Infectious Diseases, 167, 997–1002.

    Article  PubMed  CAS  Google Scholar 

  • Schmidt, A. (1997) Malassezia furfur: a fungus belonging to the physiological skin flora and its relevance in skin disorders. Cutis, 59, 21–24.

    CAS  Google Scholar 

  • Selwyn, S., Verma B. S. and Vaishnav, V. P. (1967) Factors in the bacterial colonization and infection of the human skin. Indian Journal of Medical Research, 55, 652–656.

    PubMed  CAS  Google Scholar 

  • Singh, G. (1973) Heat, humidity and pyodermas. Dermatologica, 147, 342–347.

    Article  PubMed  CAS  Google Scholar 

  • Singh, G., Marples, R. R. and Kligman, A. M. (1971) Experimental Staphylococcus aureus infection in humans. Journal of Investigative Dermatology, 57, 149–162.

    Article  PubMed  CAS  Google Scholar 

  • Stackebrandt, E., Koch, C., Gvosdiak, O. and Schumann, P. (1995) Taxonomic dissection of the genus Micrococcus: Kocuria gen. nov., Nesterkonia gen. nov., Kytococcus gen. nov., Dermacoccus gen. nov. and Micrococcus Cohn 1872 gen. emend. International Journal of Systematic Bacteriology, 45, 682–692.

    Article  PubMed  CAS  Google Scholar 

  • Stoll, T., Stucki, G., Bruhlmann, P. et al. (1996) Infection of a total knee joint prosthesis by Peptostreptococcus micros and Propionibacterium acnes in an elderly RA patient: implant salvage with longterm antibiotics and needle aspiration/ irrigation. Clinical Rheumatology 15, 399–402.

    Article  PubMed  CAS  Google Scholar 

  • Strange, P., Skov, L., Lisby, S. et al. (1996) Staphylococcal enterotoxin B applied on intact normal and intact atopic skin induces dermatitis. Archives of Dermatology, 132, 27–33.

    Article  PubMed  CAS  Google Scholar 

  • Stubbs, E., Pegler, M., Vickery A. and Harbour, C. (1994) Nasal carriage of Staphylococcus aureus in Australian (preclinical and clinical) medical students. Journal of Hospital Infection, 27, 127–134.

    Article  PubMed  CAS  Google Scholar 

  • Tenover, F. C., Arbeit, R., Archer, G. et al. (1994) Comparison of traditional and molecular methods of typing isolates of Staphylococcus aureus. Journal of Clinical Microbiology, 32, 407–415.

    CAS  Google Scholar 

  • Townsend, D. E., den Hollander, L., Bolton, S. and Grubb, W. B. (1986) Clinical isolates of staphylococci conjugate on contact with dry absorbent surfaces. Medical Journal of Australia, 144, 166.

    PubMed  CAS  Google Scholar 

  • Tucker, S. B., Rogers, R. S. III, Winkelmann, R. K. et al. (1980) Inflammation in acne vulgaris: leukocyte attraction and cytotoxicity by comedonal material. Journal of Investigative Dermatology, 74, 21–25.

    Article  PubMed  CAS  Google Scholar 

  • Vandenesch, F., Etienne, J., Reverdy, M. E. and Eykyn, S. J. (1993) Endocarditis due to Staphylococcus lugdunensis: report of 11 cases and review. Clinical Infectious Diseases, 17, 871–876.

    Article  PubMed  CAS  Google Scholar 

  • Vowels, B. R., Yang, S. and Leyden, J. J. (1995) Induction of proinflammatory cytokines by a soluble factor of Propionibacterium acnes: implications for chronic inflammatory acne. Infection and Immunity, 63, 3158–3165.

    PubMed  CAS  Google Scholar 

  • Webster, G. F., Leyden, J. J., Norman, M. E. and Nilsson, U. R. (1978) Complement activation in acne vulgaris: in vitro studies with Propionibacterium acnes and Propionibacterium granulosum. Infection and Immunity, 22, 523–529.

    CAS  Google Scholar 

  • Welbel, S. F., McNeil, M. M., Pramanik, A. et al. (1994) Nosocomial Malassezia pachydermatis bloodstream infections in a neonatal intensive care unit. Pediatric Infectious Disease Journal, 13, 104–108.

    Article  PubMed  CAS  Google Scholar 

  • Weller, T. M. A., McLardy Smith, P. and Crook, D. W. (1994) Corynebacterium jeikeium osteomyelitis following total hip joint replacement. Journal of Infection, 29, 113–114.

    CAS  Google Scholar 

  • Wenzel, R. P. and Perl, T. M. (1995) The significance of nasal carriage of Staphylococcus aureus and the incidence of postoperative wound infection. Journal of Hospital Infection, 31, 13–24.

    Article  PubMed  CAS  Google Scholar 

  • Woodgyer, A. J., Baxter, M., Rush-Munro, F. M. et al. (1985) Isolation of Dermatophilus congolensis from two New Zealand cases of pitted keratolysis. Australasian Journal of Dermatology, 26, 29–35.

    Article  PubMed  CAS  Google Scholar 

  • Yu, V. L., Goetz, A., Wagener, M. et al. (1986) Staphylococcus aureus nasal carriage and infection in patients on hemodialysis. New England Journal of Medicine, 315, 91–96.

    CAS  Google Scholar 

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Noble, W.C. (1999). The human skin microflora and disease. In: Tannock, G.W. (eds) Medical Importance of the Normal Microflora. Springer, Boston, MA. https://doi.org/10.1007/978-1-4757-3021-0_2

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