D1.139 - Staphylococcus aureus (carriage and sensitization) - is it a significant factor in allergic rhinitis?
Background
S. aureus produces a variety of proteins that can influence both the onset and progression of allergic diseases. Expanding the possibilities of diagnosing allergy to various allergens, including S. aureus enterotoxins, makes it possible to study in more detail the prevalence of carriage and hypersensitivity to individual S. aureus enterotoxins (A, B, C, TSST). And also to identify possible clinical features in the course of allergic rhinitis (AR) in patients with combined sensitization to S. aureus enterotoxins and other airborne allergens.
Method
Clinical files of 35 patients (20 patients with moderate to severe allergic rhinitis and 15 control subjects without allergic rhinitis) were analyzed. Data included:
• skin prick tests with airborne allergens, determination of total IgE and specific IgE to confirm allergic rhinitis;
• determination of allergic rhinitis severity according to ARIA recommendations;
• bacterial culture of nasal material;
• determination of specific IgE to S. aureus enterotoxins (A, B, C, TSST).
Results
The majority of patients in the allergic rhinitis group were women (12 women and 8 men). 12 patients from the AR group had carriage of S. aureus, 2 patients had carriage of S. aureus and Klebsiella pneumonia, 6 patients had a normal flora (S. epidermidis up to 10*3 CFU/ml). 10 patients from the AR group had positive antibodies to at least 1 staphylococcal enterotoxin. 6 out of 10 patients sensitized to S. aureus enterotoxins had a carrier level of 10*4 CFU/ml and higher.
In the control group (non-allergic patients): 5 patients were found to be carriers of S. aureus, two of whom were sensitized to 1 staphylococcal enterotoxin.
An additional observation is the combination of higher levels of total IgE and higher levels of antibodies to staphylococcal enterotoxins in patients with AR.
Conclusion
These findings indicate that patients with AR are more likely to be carriers of S. aureus and to be sensitized to its enterotoxins.
Further investigation of the relationship between the severity, features of AR and sensitization to specific S. aureus enterotoxins will allow us to better understand the impact of S. aureus sensitization on the course of AR and optimize the treatment of patients with this comorbidity. Further studies with a larger number of patients are needed to detail the co-sensitization profiles and statistically validate the relationships.
