Young-Chan Kim1, Ha-Kyeong Won2, Ji Won Lee3, Kyoung-Hee Sohn4, Min-Hye Kim5, Tae-Bum Kim2, Yoon-Seok Chang6, Byung-Jae Lee7, Sang-Heon Cho1, Claus Bachert8, Woo-Jung Song9. 1. Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea; Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea. 2. Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Department of Allergy and Immunology, Asan Institute for Life Sciences, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. 3. Department of Allergy and Immunology, Asan Institute for Life Sciences, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. 4. Department of Internal Medicine, Kyung Hee University Hospital, Seoul, Korea. 5. Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Korea. 6. Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea; Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. 7. Division of Allergy, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. 8. Upper Airways Research Laboratory, Ghent University Hospital, Ghent, Belgium. 9. Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Department of Allergy and Immunology, Asan Institute for Life Sciences, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. Electronic address: swj0126@amc.seoul.kr.
Abstract
BACKGROUND: Staphylococcus aureus (SA) is a frequent colonizer in humans, and it is known to be associated with chronic allergic diseases including asthma. Recent individual studies suggested that nasal SA colonization may be positively associated with asthma. OBJECTIVE: To examine relationships between nasal SA colonization and asthma prevalence and activity in adults. METHODS: Electronic databases were searched for studies published until June 2018. Studies that reported nasal SA colonization prevalence and asthma outcome (prevalence and disease activity) in general adult populations or patients with chronic rhinosinusitis (CRS) were included. Random effects meta-analyses were performed to calculate pooled odds ratio (OR) of the relationships. Subgroup analysis was conducted for the presence of nasal polyps within CRS populations. RESULTS: A total of 21 cross-sectional studies were identified, and the data from 16 studies using culture methods for SA detection were meta-analyzed (5 general population-based studies and 11 studies of patients with CRS). In studies of general populations, nasal SA colonization had significant relationships with asthma prevalence (OR 1.19; 95% confidence interval [CI] 1.06-1.34; I2 = 1%). In studies of patients with CRS, positive associations were also found but had a considerable heterogeneity (OR 1.87; 95% CI 1.18-2.97; I2 = 72%). However, the results were comparable between CRS with and without nasal polyps. CONCLUSIONS: This study demonstrated modest but significant relationships between nasal SA colonization and asthma, supporting potential roles of SA in adult patients with asthma. Further longitudinal cohort and intervention studies are warranted to identify host determinants and to clarify causality of the relationships.
BACKGROUND:Staphylococcus aureus (SA) is a frequent colonizer in humans, and it is known to be associated with chronic allergic diseases including asthma. Recent individual studies suggested that nasal SA colonization may be positively associated with asthma. OBJECTIVE: To examine relationships between nasal SA colonization and asthma prevalence and activity in adults. METHODS: Electronic databases were searched for studies published until June 2018. Studies that reported nasal SA colonization prevalence and asthma outcome (prevalence and disease activity) in general adult populations or patients with chronic rhinosinusitis (CRS) were included. Random effects meta-analyses were performed to calculate pooled odds ratio (OR) of the relationships. Subgroup analysis was conducted for the presence of nasal polyps within CRS populations. RESULTS: A total of 21 cross-sectional studies were identified, and the data from 16 studies using culture methods for SA detection were meta-analyzed (5 general population-based studies and 11 studies of patients with CRS). In studies of general populations, nasal SA colonization had significant relationships with asthma prevalence (OR 1.19; 95% confidence interval [CI] 1.06-1.34; I2 = 1%). In studies of patients with CRS, positive associations were also found but had a considerable heterogeneity (OR 1.87; 95% CI 1.18-2.97; I2 = 72%). However, the results were comparable between CRS with and without nasal polyps. CONCLUSIONS: This study demonstrated modest but significant relationships between nasal SA colonization and asthma, supporting potential roles of SA in adult patients with asthma. Further longitudinal cohort and intervention studies are warranted to identify host determinants and to clarify causality of the relationships.
Authors: Teresa Del Rosal; Ana Méndez-Echevarría; Cesar Garcia-Vera; Luis Escosa-Garcia; Martin Agud; Fernando Chaves; Federico Román; José Gutierrez-Fernandez; Enrique Ruiz de Gopegui; Guillermo Ruiz-Carrascoso; Maria Del Carmen Ruiz-Gallego; Albert Bernet; Sara Maria Quevedo; Ana Maria Fernández-Verdugo; Jesús Díez-Sebastian; Cristina Calvo Journal: Infect Drug Resist Date: 2020-12-23 Impact factor: 4.003